Why cricothyrotomy not tracheotomy ..

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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