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Surgical airway management (bronchotomy or laryngotomy) is the medical procedure ensuring an open
A needle cricothyrotomy is similar to a cricothyrotomy, but instead of making a scalpel incision, a large over-the-needle catheter is inserted (10- to 14-gauge). This is considerably simpler, particularly if using specially designed kits. This technique provides very limited airflow. The delivery of oxygen to the lungs through an over-the-needle catheter inserted through the skin into the trachea using a high pressure gas source is considered a form of conventional ventilation called percutaneous transtracheal ventilation (PTV).
airway
The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa.
Air is breathed in through the nose to th ...
between a patient’s lung
The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of t ...
s and the outside world. Surgical methods for airway management rely on making a surgical incision below the glottis
The glottis is the opening between the vocal folds (the rima glottidis). The glottis is crucial in producing vowels and voiced consonants.
Etymology
From Ancient Greek ''γλωττίς'' (glōttís), derived from ''γλῶττα'' (glôtta), va ...
in order to achieve direct access to the lower respiratory tract, bypassing the upper respiratory tract. Surgical airway management is often performed as a last resort in cases where orotracheal and nasotracheal intubation are impossible or contraindicated. Surgical airway management is also used when a person will need a mechanical ventilator for a longer period. The surgical creation of a permanent opening in the larynx
The larynx (), commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about ...
is referred to as laryngostomy.
Surgical airway management is a primary consideration in anaesthesia, emergency medicine
Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...
and intensive care medicine.
Surgical methods for airway management include cricothyrotomy
A cricothyrotomy (also called cricothyroidotomy) is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by a foreign body, angioedema, or ...
and tracheostomy
Tracheotomy (, ), or tracheostomy, is a surgical airway management procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the Vertebrate trachea, trache ...
History
Asclepiades of Bithynia
Asclepiades ( el, Ἀσκληπιάδης; c. 129/124 BC – 40 BC), sometimes called Asclepiades of Bithynia or Asclepiades of Prusa, was a Greek physician born at Prusias-on-Sea in Bithynia in Anatolia and who flourished at Rome, where he pr ...
is credited with being the first person who proposed bronchotomy as a surgical procedure, though he never attempted to perform one. Aretaeus of Cappadocia thought the procedure dangerous even as a remedy for choking, since the resulting incision "''would not heal, as being cartilaginous''"; Caelius Aurelianus also rejected its usefulness.
Cricothyrotomy
A cricothyrotomy is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by a foreign body, angioedema, or massive facial trauma. A cricothyrotomy is nearly always performed as a last resort in cases where orotracheal and nasotracheal intubation are impossible or contraindicated. Cricothyrotomy is easier and quicker to perform than tracheotomy, does not require manipulation of the cervical spine and is associated with fewer complications.Needle cricothyrotomy
A needle cricothyrotomy is similar to a cricothyrotomy, but instead of making a scalpel incision, a large over-the-needle catheter is inserted (10- to 14-gauge). This is considerably simpler, particularly if using specially designed kits. This technique provides very limited airflow. The delivery of oxygen to the lungs through an over-the-needle catheter inserted through the skin into the trachea using a high pressure gas source is considered a form of conventional ventilation called percutaneous transtracheal ventilation (PTV).
Tracheotomy
A tracheotomy is a surgically created opening from the skin of the neck down to the trachea. A tracheotomy may be considered where a person will need to be on a mechanical ventilator for a longer period. The advantages of a tracheotomy include less risk of infection and damage to the trachea such as tracheal stenosis.See also
*Airway management
Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either cl ...
* Invasive airway management
* Thyrotomy :''Thyrotomy may also refer to the cutting or biopsy the thyroid gland.''
Thyrotomy (also called thyroidotomy, median laryngotomy, laryngofissure or thyrofissure) is an incision of the larynx through the thyroid cartilage.
See also
* Laryngotomy ...
* List of surgeries by type
References
{{Respiratory system surgeries and other procedures Otorhinolaryngology