Return to: Tracheotomy - Tracheostomy or Four-flap Epithelial Lined Tracheotomy

Video

Clinical History

• Clinical Background: Tracheomalacia status post previous standard tracheotomy (subsequently removed)
  • Untreated OSAS; morbid obesity
  • Diabetes
  • Other cardiopulmonary comorbidities.
• Findings on endoscopy and at time of tracheotomy
  • Firm narrowing of trach 3.8 cm below VCS (upper aspect of previous tracheotomy)
  • Large thyroid isthmus
• Note an alternative is to use an obturator fashioned by an anaplastologist or dental prosthedontist as per Harley (1971) and Friedberg (1974)

References

Friedberg SA, Azem K and Wallner LJ: Tracheostome Maintenance by Obturator for Prolonged or Future Need Annals of Otology, Rhinology & Laryngology 83:1974 pp 520-524

Harley WT, Rothwell US: Fabrication of tracheostomy obturators. J Prosthet Dent 25:679-683, 1971