[Temporary cricothyrotomy in airway management]

Area of Science:

• Otolaryngology
• Anesthesiology
• Surgical Oncology

Context:

• Advanced oral cavity, pharyngeal, or laryngeal tumors complicate endotracheal intubation.
• Patients often present with dyspnea, poor general condition, and lack of cooperation.
• Existing scars from prior surgeries or radiation further challenge airway management.

Purpose:

• To evaluate the efficacy and safety of temporary cricothyrotomy in managing difficult airways due to extensive upper airway tumors.
• To assess the feasibility of securing ventilation and oxygenation via cricothyrotomy before definitive airway management.

Summary:

• Cricothyrotomy was performed under local anesthesia in 16 selected patients with compromised airways due to extensive tumors.
• Ventilation and oxygenation were secured, followed by general anesthesia and subsequent tracheotomy in most cases.
• Retrospective analysis indicated conventional intubation would have been nearly impossible in 10 patients; the 'cannot ventilate-cannot intubate' scenario was avoided without major complications.

Impact:

• Temporary cricothyrotomy provides an effective and convenient method for securing the respiratory tract in selected patients with challenging upper airway obstructions.
• This technique mitigates the risks associated with failed intubation attempts in critically ill cancer patients.
• Successful airway management through cricothyrotomy improves patient outcomes and safety during oncologic procedures.