Abstract
Life-threatning bleeding from the innominate artery is sometimes observed as a complication after total laryngectomy. Circulatory insufficiency with the use of a cuff enhances the necrotic process of the tracheal wall, and the tip of the tracheal cannula may provoke pressure necrosis on the anterior wall of the trachea and progressively injure the innominate artery. This hazardous complication is possible, if an improperly shaped cannula is used. The flexion of the tracheal cannulae available as commercial products can not match the trachea after total laryngectomy, because the trachea goes actually almost straight down to the carina, showing only a very slight curvature, this is clearly demonstrated in the MRI of laryngectomized patients. For the prevention of this complication, a new tracheal cannula has been developed, that is almost straight and matches the trachea of laryngectomized patients.
