Document Detail


Surgical tracheostomy in morbidly obese patients: technical considerations and a two-flap technique for access.
MedLine Citation:
PMID:  22284768     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:In an era in which percutaneous tracheostomies are frequently performed in 'suitable' necks, more technically complex cases are referred to the otolaryngologist. We describe the surgical technique used and close cooperation required in securing the airway of a morbidly obese patient.Case report:A 52-year-old, morbidly obese man with significant comorbidities was referred for surgical tracheostomy following spinal fractures. This was complicated by a previous percutaneous dilatational tracheostomy scar. Tension-free skin advancement was not possible with a deeply plunging trachea; a vertical skin incision was dropped inferiorly to the sternum for access. A size 8 Shiley XLT Proximal Extension cuffed tracheostomy tube was inserted successfully.Conclusion:We describe safe airway surgery in a morbidly obese man, and outline requirements including the use of a specially designed operating table, the need for an elongated proximal limb tracheostomy tube, and the use of a distal two-flap technique for access to a deeply plunging trachea.
Authors:
S G Khoo; N Rajaretnam
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-30
Journal Detail:
Title:  The Journal of laryngology and otology     Volume:  -     ISSN:  1748-5460     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706896     Medline TA:  J Laryngol Otol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-4     Citation Subset:  -    
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, Mater University Hospital, Dublin, Ireland.
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