Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.
Acta Otolaryngol. 2021 Apr;141(4):403-407. doi: 10.1080/00016489.2021.1871645. Epub 2021 Jan 29.
Cricotracheostomy, a modified procedure to open the airway with partial cricoid cartilage resection, was recently reported to be useful in selected cases.
AIMS/OBJECTIVES: To examine decannulation outcomes in patients who underwent cricotracheostomy by comparing it with a conventional tracheostomy.
Data from 127 consecutive adult patients, who underwent either conventional tracheostomy or cricotracheostomy between 2016 and 2019, were collected and analyzed with respect to subsequent decannulation with stoma closure.
Conventional tracheostomy and cricotracheostomy were performed in 94 and 33 patients, respectively. The most frequent reason for choosing cricotracheostomy was a physiological low-lying larynx ( = 12). After excluding 30 patients who were considered ineligible due to their primary disease, subsequent decannulation with stoma closure was achieved in 35 (46%) of 76 cases with conventional tracheostomy and seven (33%) of 21 cases with cricotracheostomy, showing no significant difference ( = .33).
CONCLUSIONS/SIGNIFICANCE: Compared with a conventional tracheostomy, cricotracheostomy had an acceptable decannulation outcome. However, it should be emphasized that an appropriate selection of patients is required on considering the advantages of cricotracheostomy.
环甲切开术是一种改良的气道开放术，通过部分环状软骨切除来实现，最近有报道称其在某些特定病例中具有一定的应用价值。
目的/目标：通过比较环甲切开术与常规气管切开术，来评估接受环甲切开术患者的拔管结局。
收集了 2016 年至 2019 年间连续 127 例成年患者的数据，这些患者分别接受了常规气管切开术或环甲切开术，并对后续带管闭瘘的拔管情况进行了分析。
常规气管切开术和环甲切开术分别在 94 例和 33 例患者中进行。选择环甲切开术的最常见原因是生理性低位喉（ = 12）。排除因原发疾病而被认为不适合的 30 例患者后，在接受常规气管切开术的 76 例患者中，有 35 例（46%）实现了后续带管闭瘘，而在接受环甲切开术的 21 例患者中，有 7 例（33%）实现了后续带管闭瘘，两组间无显著差异（ = .33）。
结论/意义：与常规气管切开术相比，环甲切开术具有可接受的拔管结局。然而，应该强调的是，在考虑环甲切开术的优势时，需要对患者进行适当的选择。
