Suspension laryngoscopy‐assisted percutaneous dilatational tracheostomy in high‐risk patients

White, Hilliary N.; Sharp, Dawn B.; Castellanos, Paul F.

doi:10.1002/lary.21019

Cited by 12 publications

(34 citation statements)

References 20 publications

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“…3,4 Relative contraindications include obesity, coagulopathy, need for positive end-expiratory pressure of >20 cm of water, and evidence of infection at the prospective surgical site. 3,4 Only a handful of studies exist in medical literature addressing the safety of PDT in obese patients. In 2000, Mansharamani et al presented the first case series of PDT successfully performed on 13 consecutive obese patients with a body mass index (BMI) >27 kg/m 2 with minimal complications.…”

Section: Introductionmentioning

confidence: 99%

“…Most publications consider cervical spine injury, pediatric age <8 years old, gross distortion of the neck anatomy, unidentifiable landmarks, visible large blood vessels in the operative field, and the need for emergent airway as absolute contraindications. 3,4 Relative contraindications include obesity, coagulopathy, need for positive end-expiratory pressure of >20 cm of water, and evidence of infection at the prospective surgical site. 3,4 Only a handful of studies exist in medical literature addressing the safety of PDT in obese patients.…”

Section: Introductionmentioning

confidence: 99%

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Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient

2012

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient

2012

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“…Percutaneous dilatational tracheostomy under laryngosuspension is a blending of two techniques [12,13]. In this technique, ventilation and hemostasis are secured during the entire procedure with permanent and easy access to the airway in case of complication [12,13]. Here, we present an evaluation of this technique that allows tracheostomy to be performed with maximal safety in the setting of emergency or elective procedure.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of percutaneous dilatational tracheostomy under laryngosuspension

Moulin

Aboussouan

Castellanos

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose To describe the technique and outcomes of percutaneous tracheostomy under laryngosuspension. Methods A consecutive series of patients who underwent percutaneous tracheostomy under laryngosuspension were reviewed for outcomes. The procedure is performed under general anesthesia and laryngosuspension. An 8.5 oral endotracheal tube is inserted and the cuff is inflated in the supraglottis, allowing access to the whole trachea and subglottis. The tube is taped to the laryngoscope. A rigid endoscope is inserted in the endotracheal tube through a swivel connector connected to the tube and the ventilation circuit. Percutaneous tracheostomy kit is used to perform dilatational tracheostomy at the desired level of the trachea under direct visual endoscopic control. Results Forty-eight patients underwent percutaneous tracheostomy under laryngosuspension. Thirty-two cases were performed in an emergency after securing the airway with endotracheal intubation. In all other cases, tracheostomy was performed as a part of an elective procedure affecting the airway or in patients requiring prolonged ventilation. More than half of patients were considered high risk by virtue of one or more of the following: morbid obesity, prior neck surgery, prior neck radiotherapy, progressive head and neck cancer, or laryngotracheal stenosis. Complications occurred in seven cases. Conclusion Percutaneous tracheostomy under laryngosuspension has the advantage of optimal control of patient ventilation and hemostasis throughout the procedure. High-quality endoscopic vision and easy access to the airway under laryngosuspension allow tracheostomy to be performed with maximum safety.

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“…In the past two decades, this technology has gradually been replaced by percutaneous dilatational tracheostomy (PDT) [2][3][4][5][6][7]. Despite the rapid evolution and improvements in technique of PDT, there continues to be apprehension in the medical community about its applicability to the high-risk patient [8,9]. In difficult tracheotomy, patients suffered postposture cervical spine injury, chunky neck, anatomic variations, respiratory failure requiring positive end-expiratory pressure (PEEP), and were affected by not tolerating a long time of breathing machine offline and intubation difficulties [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…The above two tracheotomies all have some kinds of incision difficulties or relative contraindications. Many domestic or foreign scholars [9,[12][13][14] have already described the causes and countermeasures of difficult tracheotomy. In this paper, we devised an advanced method for tracheal incision, the experience of the author of percutaneous dilatational tracheotomy kit (PDTk) applied into ST (hereinafter abbrev.…”

Section: Introductionmentioning

confidence: 99%

Technical Improvements of Difficult Tracheotomy

2014

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The aim of this study was to explore the application value of technical improvements of difficult tracheotomy. Percutaneous dilatational tracheotomy kit combined with traditional surgical tracheotomy was performed on seven patients with various types of difficult tracheotomy surgery from Jan. 2011 to Mar. 2013 in our hospital. The indicators, such as difficulty degree and intraoperative peripheral oxygen saturation changes of each patient, were assessed and analyzed. The average operating time was 20 min (from the beginning of skin incision to the implantation of the tracheal tube), and the time from cutting out tracheal cartilage rings to completely implanting tracheal tube was with 2 min; the intraoperative oxygen saturation degrees were all above 92 %. There were no serious complications, such as intraoperative hemorrhea, asphyxia, cardiac arrest, or others, and no complications, such as postoperative bleeding, pneumothorax, cervical spinal cord injury, tracheal stenosis, tracheoesophageal fistula, or others, appeared. The technical improvements used in difficult tracheotomy could reduce the risk of surgery, difficulties of the surgical operation and postoperative complications and make the operation much more easy and more suitable for the clinical application.

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Suspension laryngoscopy‐assisted percutaneous dilatational tracheostomy in high‐risk patients

Cited by 12 publications

References 20 publications

Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient

Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient

Evaluation of percutaneous dilatational tracheostomy under laryngosuspension

Technical Improvements of Difficult Tracheotomy

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