The higher complication rate of emergency tracheotomy, compared to cricothyrotomy,results from the fact that the trachea is situated deeper in the neck, the posterior tracheal wall lacks the protection of a circumferential cricoid cartilage (increasing the risk of esophageal perforation), there is a greater abundance of adjacent vascular structures, and there is a proximity of the thyroid gland and lung. The palpable, often visible, surface landmarks of the thyroid and cricoid cartilages and the ability to accomplish the task faster, with a minimum of equipment, make emergency cricothyrotomy more attractive than tracheotomy, for the surgeon and nonsurgeon alike.
As a consequence, all of the techniques with the exception of percutaneous dilational tracheotomy and possibly needle insufflation in children will involve access to the airway through the cricothyroid membrane (CTM).
| Ger R, Evans JT. Tracheostomy: an anatomico-clinical review. Clin Anat. 1993;6:337-341. |
| Brantigan CO, Grow JB, Sr. Cricothyroidotomy: elective use in respiratory problems requiring tracheotomy. J Thorac Cardiovasc Surg. 1976;71:72-81. [PMID: 1249960] |
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