Abstract Tracheal fenestration1-5 is a new operative procedure for the treatment of chronic respiratory diseases. It is a skin-lined cervical tracheocutaneous communication equipped with two door-like skin valves at its external end. The valves can be opened at will for the purpose of tracheobronchial aspiration and medication, or self-aspiration and self-medication. When the valves are not held apart, the tracheocutaneous communication is airtight and leakproof; phonation and the cough mechanism remain normal. The purpose of this paper is to present the detailed surgical technique of tracheal fenestration, based on experience with 26 cases. Operative Technique A 4 in. long transverse skin incision is made over the lower anterior surface of the neck, about the level of the cricoid cartilage. This incision is then extended in such a way that one skin flap is outlined above, and one below, the level of the initial transverse incision. The base of each opposing References 1. Suture carriers, pickup forceps, tracheotomy cannulas, and tracheotome (Items 1, 2, 3, 4, and 5) manufactured by George P. Pilling & Son Company, 3451 Walnut St., Philadelphia) 2. Selective bronchial suction catheters manufactured by, and Detergicide distributed by, C. R. Bard, Inc., Summit, N.J. (Items 6 and 7). 3. Tracheal fenestration sterilizing and serving trays manufactured by MO-AN Research Equipment Co., 62-05 84th St., Middle Village 79, N.Y. (Items 8 and 9). 4. Tracheal fenestration suction unit manufactured by C. M. Sorensen Co., 50-19 47th Ave., Woodside 77, N.Y. (Item 10). 5. Rockey, E. E.; Mayer, E., and Rappaport, I.: Tracheal Fenestration , Dis. Chest 30:224, 1956.Crossref 6. Rockey, E. E.: Surgical Technic of Tracheal Fenestration , Am. J. Surg. 94:486, 1957.Crossref 7. Rockey, E. E.; Thompson, S. A.; Epstein, I. G.; Wasserman, E., and Ahn, K. J.: Tracheal Fenestration as a New Method for the Therapeutic Management of Chronic Pulmonary Diseases and for the Experimental Exploration of the Bronchial Tree , Am. Rev. Tuberc. 78:815, 1958. 8. Rockey, E. E.; Thompson, S. A.; Blazsik, C. F., and Aim, K. J.: Tracheal Fenestration as a New Method of Treatment for Advanced Emphysema , New York J. Med. 58:3607, 1958. 9. Rockey, E. E.; Thompson, S. A., and Blazsik, C. F.: The Evolution and Early Results of Tracheal Fenestration , Am. Rev. Tuberc. 79:773, 1959. 10. Rockey, E. E., and Thompson, S. A.: Selective Bronchial Suction Catheters and Their Clinical Application , Am. J. Surg. 96:552, 1958.Crossref
A.M.A. Archives Surgery – American Medical Association
Published: Dec 1, 1959
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