HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gomes, M. N. Articles by Spear, S. L. Search for Related Content PubMed PubMed Citation Articles by Gomes, M. N. Articles by Spear, S. L.

The Annals of Thoracic Surgery, Vol 43, 539-543, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

Mediastinal tracheostomy

MN Gomes, S Kroll and SL Spear

Upper airway obstruction in primary or recurrent carcinomas of the head and neck extending into the mediastinum may demand surgical intervention despite severe technical difficulties in patients with tumors previously considered inoperable. In fact, many of these tumors may be operable and some perhaps curable. A technique has been developed based in part on our experience with previously described procedures. A preliminary sternal split is used to demonstrate the extent of the mediastinal involvement as well as to provide enhanced exposure and proximal control of the great vessels. The pectoralis major muscle is used with a generous flap of overlying skin comprising nearly half of the anterior portion of the chest. A tracheostomy is then created in a fashion similar to the placement of a cardiac valvular prosthesis by creating a circular defect in the pectoralis major flap and suturing it to the tracheal remnant. This technique offers a reasonably safe and reliable means of creating a low anterior mediastinal tracheostomy for tumors previously considered inoperable. The preliminary sternal split makes the procedure safer and easier to perform, and the use of a very large pectoralis major island flap allows for reliable closure of the resulting mediastinal and sternal defects.

This article has been cited by other articles:

				Y. Kuwabara, A. Sato, M. Mitani, N. Shinoda, K. Hattori, T. Suzuki, and Y. Fujii Use of omentum for mediastinal tracheostomy after total laryngoesophagectomy Ann. Thorac. Surg., February 1, 2001; 71(2): 409 - 413. [Abstract] [Full Text] [PDF]

				G. D. Trachiotis and W. R. Hix Repair of Tracheogastric Fistula After Cervical Exenteration Ann. Thorac. Surg., February 1, 1996; 61(2): 719 - 721. [Abstract] [Full Text]