Abstract
Tracheostomy, which is often performed in the emergency department, is associated with lethal complications, such as arterial injury and tracheostomy vascular fistula. We performed a hybrid tracheostomy with the AdjustFit® and BLUperc® behind the thyroid gland to avoid direct contact of the innominate and carotid arteries. In the three cases we describe herein, the innominate or common carotid artery was close to the caudal side of the thyroid gland. Therefore, we dissected the thyroid gland from the head side to the back and punctured the tracheal tube between the second and third tracheal cartilages. In both cases, a small incision （20 mm） was made without any complications. As the thyroid gland is between the tracheal tube and the adjacent artery, this technique is safe and useful for treating cervical diseases that are in close proximity to blood vessels.
