TY - JOUR
T1 - Tracheostomy in Tortuous Brachiocephalic Artery
AU - Hori, Yoko
AU - Hashimoto, Sho
AU - Katori, Yukio
AU - Koiwa, Tetsuo
AU - Hozawa, Koji
AU - Kobayashi, Toshimitsu
PY - 2004
Y1 - 2004
N2 - Tracheostomy, frequently used to ensure airway maintenance, involves complications such as bleeding and pneumothorax. Major vessel damage is also a lethal complication that must be avoided. We report tracheostomy in a case of tortuous bracheocephalic artery. A 74-year-old female with slight dyspnea due to amyotrophic lateral sclerosis (ALS) referred for tracheostomy had a pulsating mass in front of the trachea, found in by magnetic resonance (MR) imaging and MR angiography to be a tortuous bracheocephalic artery. In surgery, the displaced bracheocephalic artery was confirmed between the sternothyroid muscle and lower pole of the thyroid gland. This vessel was carefully dissected, the thyroid gland was divided at the isthmus, and the anterior wall of the trachea was fenestrated in an inverted U shape. The flap created by fenestration protected the vessel wall and was sutured to the skin so the vessel would not be exposed to the tracheostoma. A tortuous major artery is not uncommon in the neck, and care should be taken to avoid damaging such a vessel during tracheostomy.
AB - Tracheostomy, frequently used to ensure airway maintenance, involves complications such as bleeding and pneumothorax. Major vessel damage is also a lethal complication that must be avoided. We report tracheostomy in a case of tortuous bracheocephalic artery. A 74-year-old female with slight dyspnea due to amyotrophic lateral sclerosis (ALS) referred for tracheostomy had a pulsating mass in front of the trachea, found in by magnetic resonance (MR) imaging and MR angiography to be a tortuous bracheocephalic artery. In surgery, the displaced bracheocephalic artery was confirmed between the sternothyroid muscle and lower pole of the thyroid gland. This vessel was carefully dissected, the thyroid gland was divided at the isthmus, and the anterior wall of the trachea was fenestrated in an inverted U shape. The flap created by fenestration protected the vessel wall and was sutured to the skin so the vessel would not be exposed to the tracheostoma. A tortuous major artery is not uncommon in the neck, and care should be taken to avoid damaging such a vessel during tracheostomy.
KW - Complication
KW - Tortuous major artery
KW - Tracheostomy
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U2 - 10.3950/jibiinkoka.107.152
DO - 10.3950/jibiinkoka.107.152
M3 - Article
C2 - 15032005
AN - SCOPUS:1542377683
VL - 107
SP - 152
EP - 155
JO - Journal of Otolaryngology of Japan
JF - Journal of Otolaryngology of Japan
SN - 0030-6622
IS - 2
ER -