Jet ventilation during tracheal reconstruction

Abstract

We report a case of tracheal reconstruction using high-frequency jet ventilation (HFJV) without operative field intubation. The patient was a 68-year-old woman with a raised mass (adenoid cystic carcinoma) in the cervical trachea, who was scheduled for tracheal reconstruction with curative intent. Initial airway management under anesthesia involved endotracheal intubation with a standard tracheal tube, and surgery was performed using a cervical approach. When tracheal detachment around the mass was finished, we exchanged the tracheal tube for an airway exchange catheter (Cook Medical Inc., Bloomington, IN, USA) and initiated HFJV via the catheter. We then resected the second to fourth tracheal cartilages followed by tracheal end-to-end anastomosis, and HFJV through the thin airway exchange catheter allowed us to avoid operative field intubation. Airway surgery using HFJV with a thin catheter is an acceptable method of airway management, and it provides a clear view of the surgical field.