Role of cricothyroid cannulation in head and neck surgery

J Laryngol Otol. 2008 Oct;122(10):1096-9. doi: 10.1017/S0022215107001594. Epub 2008 Feb 20.

Abstract

Objectives: This paper outlines our use of cricothyroid cannulation in those patients undergoing head and neck surgery in whom a 'difficult airway' is anticipated. Audit results are presented.

Materials and methods: Prospective data collection for all patients undergoing cricothyroid cannulation for management of head and neck neoplasms, over a two-year period.

Results: Thirty-nine cricothyroid cannulae were sited in 32 patients. All patients with laryngeal tumours underwent the procedure while awake, prior to the anticipated difficult intubation, and the cannulae were removed within six hours. Most cannulations performed under general anaesthetic were for anticipated 'dangerous extubations' in patients with oral cavity tumours, and these cannulae remained in place for 24 hours. Tracheostomy was possibly avoided in six patients. No complications were identified.

Conclusion: Cricothyroid cannulation can be a simple, safe, reliable technique which is a useful adjunct in the management of patients with a potentially difficult airway.

MeSH terms

  • Airway Obstruction / therapy*
  • Humans
  • Intubation, Intratracheal / methods*
  • Laryngeal Neoplasms / surgery
  • Laryngeal Neoplasms / therapy*
  • Perioperative Care
  • Tracheostomy / methods*