Intraoperative Tracheostomy Tube Customization
Intraoperative Tracheostomy Tube Customization作者机构：Aga Khan University Karachi Pakistan Head & Neck Institute Cleveland Clinic Foundation Cleveland USA
出 版 物：《International Journal of Otolaryngology and Head & Neck Surgery》 (耳鼻喉（英文）)
年 卷 期：2013年第2卷第4期
页 面：148-150页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Tracheostomy Tube Customized
摘 要：Objectives: This article describes how to make a customized tracheostomy tube immediately in the operating room setting. This is particularly critical when a commercial customized tracheostomy tube cannot be readily obtained. Study Design: Case presentation. Methods/Results: A 73-year-old female was seen in our clinic for management of a recurrent invasive paraganglioma of the thyroid. She underwent a total laryngopharyngectomy, cervical esophagectomy, and anterolateral thigh free flap reconstruction followed by post-operative radiation. In follow-up, the patient presented with dyspnea related to two areas of stenosis, one at the level of her stoma and one at the distal trachea. The patient was therefore taken to the operating room urgently for dilation and placement of a tracheostomy tube. Available tracheostomy tubes were tried and ill fitting as each tube narrowed the patient’s stoma or abutted her distal granulation tissue. To custom create a tracheostomy tube, we used a standard rib shearer to shorten a #6 uncuffed tracheostomy tube by 2 cm. The edges were further smoothed and beveled using sand paper and a diamond burr drill. The finished product was a wide diameter tube with a custom length suited to our patient. Conclusions: Although a simple solution, the use of a rib shearer provides a quick and feasible solution to creating custom length tracheostomy tubes in situations where custom length tubes are needed yet unavailable.
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