Tracheal airway for use during total laryngectomy

TRACHEAL

AIRWAY

FOR USE DURING TOTAL

LARYNGECTOMY * HAYES Attending

MARTIN,

Surgeon,

lllemorial

M.D. Hospital

New York, New York

D

cartilage, it is desirabIe that the dista1 tracheal stump be heId out of the way so that no blood enters the tracheobronchial

URING

performance of total Iaryngectomy when the trachea has been transected just below the cricoid

FIG. I. Breathing tube for laryngectomy which consists of a tapered nngIed tube with two detachable ends (large and smaI1). A useful devise to hold the trachea1 stump out of the way so that blood will not enter the tracheobronchial tree.

FIG. z. Diagram showing tube in pIace during laryngectomy. The trachea is cut across just above its upper ring and the breathing cannuIa is inserted into the open end of the trachea. Two heavy sutures are passed through the trachea1 wall and wrapped around the angIed tube to keep it in place. * From the Head and Neck Service,

hlemorial

HospitaI for the Treatment York, N. Y. 755

of Cancer

and Allied Diseases, New

756

American

Journal

of Surgery

Martin-Tracheal

tree. This phase of the operation may be particuIarIy troubIesome to. the patient and annoying to the surgeon, especiaIIy when operating on individuals with bIeeding tendencies. If the trachea1 stump can be pIugged with a tapered tube which is bent at such an angIe so as not to be in the way of the operator, the safety factor of the surgica1 procedure is increased and no unnecessary time consumed.

Airway

MAY,

1948

The device shown* in the accompanying diagram consists of a tapered angIed tube and is provided with two detachabIe ends of different sizes, large and small. (Fig. I.) The tube is heId in pIace by passing a heavy suture through the stump and winding it severa times around the tube. (Fig. 2.) *This instrument is manufactured by and may be purchased from the United Surgical Supply Company

G. GOGGI reports two instances of tubercuIosis of the thyroid both proven histologically. Both patients also had tuberculous Iesions ekewhere. In one, surgery was contraindicated because of advanced osseous tuberculosis and the “acuteness”. of the degree of the perithyroid tuberculosis infihration that was aIso present. The other woman had a coId abscess in an adenoma of the thyroid, but her general condition was better and her pulmonary tuberculosis was heaIed. Hence, a partial thyroidectomy was done in her case. (Richard A. Leonardo, M.D.)