Origin of the cannula for tracheotomy during the middle ages and Renaissance

The purpose of this article was to trace the historical origin of the inserted cannula during tracheotomy. Tracheotomy is mentioned in most ancient medical texts, but the origin of cannula insertion into the windpipe is unclear. We reviewed the incunabula and Renaissance texts reporting the utilization of surgical cannulas and tracheotomy. The incunabula disclosed extended use of surgical cannulas during the middle ages and Renaissance. Although tracheotomy was advocated in acutely suffocating patients for a disease of the throat termed squinantia or angina, the first report of the procedure was found only at the end of the middle ages and a second during the middle Renaissance. The introduction of cannula use in tracheotomy was supported by a semantic misinterpretation by Antonio Musa Brasavola. The historical origin for tracheotomy in the middle ages and Renaissance is conflicting. Antonio Brasavola wrongly interpreted Avicenna's oral cannula introduced into the windpipe for angina. This misinterpretation allowed Giulio Casserio to draw the first curved cannula introduced for used during tracheotomy.