Abstract
Percutaneous dilational tracheostomy (PDT) has gained popularity among critical care specialists in the past 10 years. As a new technique, PDT is often used for the patients after cardiac surgery to prevent mediastinal infection caused by tracheostoma. Some studies suggest potential advantages of PDT relative to surgical tracheostomy, including ease of performance, and lower incidence of peristomal bleeding and postoperative infection. With PDT, the trachea is normally punctured between the first and second tracheal cartilages or in the subcricoid level. Although some surgeons perform PDT in the cricothyroid membrane in order to isolate the tracheostoma from a median sternotomy wound, to date there are no safety standards for percutaneous cricothyroidotomy. Here, we report two cases of subglottic stenosis caused by percutaneous cricothyroidotomy using Ciaglia Blue Rhino® (CBR;Cook Critical Medical Care, USA). The CBR involves one-step dilation by means of a curved dilator with hydrophilic coating. These two cases suggest that PDT in the cricothyroid membrane can lead to subglottic stenosis.
