Cricothyroidotomy versus tracheotomy: an otolaryngologist's perspective.

A series of 655 elective cricothyroidotomies presented by Brantigan and Grow in 1975 has fueled a recent explosion in the number of cricothyroidotomies being performed for elective tracheal access. This article reviews Jackson's classic 1921 paper on cricothyroidotomy, Brantigan and Grow's series, seven recent clinical series of elective cricothyroidotomies, and our experience. Voice change is the most frequent complication of cricothyroidotomy occurring in up to 50% of cases. Chronic subglottic stenosis occurs in approximately 2% of cases. Contraindications to cricothyroidotomy include prolonged intubation, airway obstruction following extubation, and laryngeal pathology of any kind.