Percutaneous dilation tracheostomy guided by rigid bronchoscopy

Herein, we described a redo tracheostomy in a patient with a large mediastinal goitre. A percutaneous dilation tracheostomy was performed under rigid bronchoscopy. Rigid bronchoscopy provided several advantages compared with flexible bronchoscopy. It suctioned significant blood and secretions, secured the airway and ensured adequate ventilation during the entire procedure. Technically, the rigid barrel displacing the trachea anteriorly facilitated the insertion of dilators and the tracheostomy cannula and reduced the risk of airway injury. This strategy was safe and feasible and could turn out to be useful in patients with difficult airways where standard percutaneous dilation tracheostomy is difficult to perform.