Broken tracheostomy tube In the Bronchus

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Dr Shrikant Phatak

Foreign body in the airway demand urgent removal

Health & Medicine

Dr Shrikant Phatak
Consultant ENT Surgeon
Head of ENT Department
Choithram Hospital
Indore

 Tracheostomy is performed to relieve upper
airway obstruction
 If kept in situ for long term sometimes due to
corrosion of the tube by the body secretions
tube can break & blocks the lower airway
causing respiratory distress.
 Two successfully managed patients are
presented

X ray showing broken piece in the traea
in 5 years old male child

X ray showing broken piece in the
left bronchus in a 32 years old
male

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Surgical Management Of the Failed Airway: A guide to precutaneous cricothyrotomy Guidelines from Hoan E. Spiegel, MD Assistant Professor Beth Israel Ddeaconess Medical Center Harvard medical School Boston, MS Vipul Shah, MD Western Washington Medical Group Everett, Washington The first-known mention of an attempted surgical airway, a tracheostomy, was depicted on Egyptian tablets as early as 3600 BCE. History has condemned the emergent surgical airway when it has failed, but when successful, the physicians who performed it have risen in esteem to become "on a footing with the gods". Il 100 BCE, the Persian physician Asclepiades described in detail a tracheal incision for improving the airway. Yet most who advocated surgical approaches to the airway, including Asclepiades, were severely criticized. Vicq d'Azyr, a French surgeon and anatomist, first described cricothyrotomy in 1805. Emergent cricothyroidotomy /also known as cricothyrotomy, minitracheostomy, and high tracheostomy) became widely acknowledged and accepted in 1976 when Brantigan and Grow confirmed the relative safety of the procedure. A decade later, the Seldinger technique, a wire-over-needle procedure commonly used for intra-vascular cannulation, was adapted for use in obtaining both emergent and nonemergent surgical airways.

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