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Cricothyroidotomy versus tracheotomy: an otolaryngologist's perspective
1Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center, Houston.
The Laryngoscope
|February 1, 1988
Summary
Cricothyroidotomy, an elective tracheal access procedure, is increasingly common. While generally safe, voice changes affect up to 50% of patients, and chronic subglottic stenosis occurs in about 2%.
Area of Science:
- Otolaryngology
- Surgical Procedures
- Airway Management
Background:
- The 1975 series by Brantigan and Grow significantly increased elective cricothyroidotomies for tracheal access.
- Historical and recent clinical data on this procedure are reviewed.
Purpose of the Study:
- To review the historical and current literature on elective cricothyroidotomy.
- To analyze the safety and complications of cricothyroidotomy.
Main Methods:
- Literature review of key cricothyroidotomy studies, including historical papers and recent clinical series.
- Analysis of personal experience with the procedure.
Main Results:
- Voice change is the most frequent complication, reported in up to 50% of cases.
- Chronic subglottic stenosis is an infrequent but serious complication, occurring in approximately 2% of cases.
Conclusions:
- Cricothyroidotomy is a viable option for elective tracheal access.
- Potential complications, particularly voice changes and subglottic stenosis, must be considered.
- Contraindications include prolonged intubation, post-extubation airway obstruction, and existing laryngeal pathology.