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Applied anatomy for cricothyrotomy and tracheostomy

  • Harold Ellis
    Affiliations
    Harold Ellis FRCS was Professor of Surgery at Westminster Medical School until 1989. Since then he has taught anatomy, first in Cambridge and now at Guy’s Hospital, London, UK. Conflicts of interest: none declared
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      Abstract

      Tracheostomy and cricothyrotomy are means of access to the respiratory tract in upper airway obstruction. Their safe performance relies on accurate anatomical knowledge of the region. The easily palpable gap between the thyroid and cricoid cartilages demarcates the tough cricothyroid ligament that lies safely distal to the vocal cords and is the site for cricothyrotomy. Tracheostomy, either between or dividing the upper rings of the trachea, is carried out by open operation or by the percutaneous route. In these procedures it is essential to have the head fully extended to keep exactly to the midline to protect vital lateral structures.

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      Further reading

        • Ellis H.
        • Feldman S.
        • Harrop-Griffiths W.
        Anatomy for anaesthetists.
        8th edn. Oxford: Blackwell Publishing, 2004