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External light guidance for percutaneous dilatational tracheotomy
Author(s) -
ElSayed Ivan H.,
Ho James E.,
Eisele David W.
Publication year - 2011
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21610
Subject(s) - subglottis , tracheotomy , medicine , percutaneous , endotracheal tube , lumen (anatomy) , white light , surgery , glottis , larynx , intubation , optics , physics
Background Percutaneous dilatational tracheotomy (PDT) is considered a safe technique; however, there is still room for improvement. We present our initial experience with an external white light guide to position the endotracheal tube and guide needle placement during PDT. Methods This is a retrospective series of 15 consecutive patients undergoing external light–guided PDT. A white light source was placed on the anterior trachea wall externally and the transmitted light was identified in the tracheal lumen with a bronchoscopic to predict the needle entrance point. Results The transmitted light was rapidly identified in all 15 patients, facilitated endotracheal tube tip placement in the subglottis in approximately 10 seconds in 13 of 15 patients, and predicted needle penetration into the trachea within 1 to 2 mm of the external light in all patients. Conclusions External light guidance facilitates rapid, accurate placement of the needle through the tracheal wall and can reduce surgeon anxiety, especially in teaching situations. © 2011 Wiley Periodicals, Inc. Head Neck, 2011