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Cervical osteomyelitis after percutaneous transtracheal ventilation and tracheotomy
1Otolaryngology/Head and Neck Surgery, University of Washington School of Medicine, Seattle, USA.
Head & Neck
|May 1, 1996
Summary
Percutaneous transtracheal ventilation and tracheotomy are emergent airway management tools. A rare case revealed late cervical osteomyelitis as a complication, potentially due to deep neck space contamination.
Area of Science:
- Emergency Medicine
- Otolaryngology
- Infectious Disease
Background:
- Percutaneous transtracheal ventilation (PTV) is a valuable technique for emergent airway management.
- Tracheotomy is also a critical procedure for securing the airway in emergencies.
Observation:
- A 42-year-old woman experienced laryngospasm, necessitating emergency airway intervention.
- She underwent emergent cricothyroidotomy, subsequently converted to a tracheotomy, and developed massive subcutaneous emphysema.
- Despite prompt decannulation, she later developed cervical osteomyelitis.
Findings:
- Cervical osteomyelitis is a previously unreported complication of PTV and tracheotomy.
- Deep neck space contamination, potentially facilitated by pressure dissection, is hypothesized as the cause.
Implications:
- This case highlights a rare but serious complication associated with airway interventions.
- Awareness of potential deep neck space contamination is crucial in managing patients post-PTV or tracheotomy.
- Prompt diagnosis and treatment with intravenous antibiotics are effective for resolving this complication.