Three Cases of Cricotracheostomy: Safe Tracheotomy for High-Risk Cases of Tracheo-Innominate Artery Fistula and Short Neck/Low Larynx

Abstract

As medical technology advances, the indications for surgical airways have become more diverse. Cricotracheostomy is a new surgical technique that allows the shortest route to the airway and creates a tracheostomy at a high cervical position. Case 1 was an 11-year-old male with congenital myotonic dystrophy, and case 2 was a 16-year-old male with hypoxic encephalopathy. In cases 1 and 2, extubation was difficult after pneumonia, and a surgical airway was considered. However, because there was a high risk of a tracheo-innominate artery fistula (TIF), cricotracheostomy was performed. Case 3 was a 39-year-old woman with osteogenesis imperfecta. Extubation was difficult after an asthma attack, and a surgical airway was considered. However, because of the extremely short neck and low larynx, cricotracheostomy was performed. None of the three patients experienced any adverse events during or after surgery, and they have been speaking or having oral intake the same as before. It is believed that cricotracheostomy should be indicated in cases of high-risk TIF or short neck and low larynx in pediatric surgery.