Emergency cricothyroidotomy in the patient with massive neck swelling. Part 2: Clinical aspects

A technique has been described for emergency tracheotomy in a patient with massive neck swelling which utilizes the hyoid bone to permit localization of the midline of the neck and manual surgical traction of the larynx. The method for localizing the hyoid bone in a patient with massive neck swelling requires only one measurement to be taken: from the angle of the mandible to the mental protuberance. From this measurement, one can locate the hyoid bone with ease. This procedure has been performed in 5 cadavers and 7 patients with excellent results, providing rapid access to the airway within less than 2 min. The authors believe that the procedure permits rapid access to the airway in patients with massive neck swelling in whom emergency tracheotomy or cricothyroidotomy is difficult and time consuming.