Review of 280 Tracheostomies

Abstract

Summary 1. A series of 280 tracheostomies from St. Vincent's Hospital, Sydney, is reported. 2. Indications for operation are classified and figures presented to show that the operation is more common than formerly. 3. Operative techniques are described. 4. Complications, in particular those relating to cuffed tubes, are tabulated. 5. A case report of tracheo‐arterial fistula is added to the literature. 6. Overall mortality was 40 per cent.

Ulcerative tracheo-oesophageal fistula during treatment by tracheostomy and intermittent positive pressure ventilation

“…Concerning the mechanism of oesophageal damage, I believe, with many others (Johnston, Wright, and Hercus, 1967;Lord, 1967;Hunter, 1967;Toty et al, 1967;and Nicolas et al, 1967), that an ulcerative tracheo-oesophageal fistula of the type under discussion is caused by ulceration of the trachea spreading subsequently into the oesophagus. Nicolas et al (1967), however, point out that the hypothesis that the oesophagus is the origin of the process leading to a fistula with the trachea cannot be rejected without discussion.…”