[Application of modified cricothyrotomy in the multiplane surgery for severe obstructive sleep apnea hypopnea...

Objective:To explore the clinical value of modified cricothyrotomy in the multiplane surgery under general anesthesia for patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS). Method:A retrospective review was made among 20 cases with severe OSAHS treated a concurrent multiplane surgery under the condition of modified cricothyrotomy with general anesthesia, performed during recent 3 years, with their clinical data reviewed carefully. General anesthesia was carried out by inserting trachea cannula through mouth at first, and then, modified cricothyrotomy was performed via a transverse incision, followed by pulling out trachea cannula and inserting endotracheal tube through thyrocricoid incision. After this procedure, a multiplane operation was done under such a condition to treat severe OSAHS concurrently. Result:All these patients were sent back to the general ward instead of ICU after the operation, with no cervical subcutaneous emphysema occured, and one case of them bled slightly from the cervical incision during the period of hospital. Tracheal tube was pulled out successfully among these cases within 5 to 10 days. By the end of following up period for 3 months, all cervical incision of them recovered well except a dissatisfied patient due to adhesion and pull of the cervical cicatrice. After six months of follow-up, all patients were satisfied with their surgery and rehabilitation efficacy. Conclusion:Modified cricothyrotomy is easy and safe to perform, with few complications occurring and inconspicuous postoperative scar in the region of incision. Such a procedure may ensure the concurrent multiplane operation on cases with severe OSAHS performed safely as possible as it can.