TITLE:
Intraoperative Tracheostomy Tube Customization
AUTHORS:
Anne Hseu, Zain Ul Abedeen Sobani, Joseph Scharpf
KEYWORDS:
Tracheostomy Tube; Customized
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.2 No.4,
July
17,
2013
ABSTRACT: Objectives: This article
describes how to make a customized tracheostomy tube immediately in the operating
room setting. This is particularly critical when a commercial customized tracheostomy
tube cannot be readily obtained. Study Design: Case presentation. Methods/Results: A 73-year-old female was seen in our clinic for management of a recurrent invasive
paraganglioma of the thyroid. She underwent a total laryngopharyngectomy, cervical
esophagectomy, and anterolateral thigh free flap reconstruction followed by post-operative
radiation. In follow-up, the patient presented with dyspnea related to two areas
of stenosis, one at the level of her stoma and one at the distal trachea. The patient
was therefore taken to the operating room urgently for dilation and placement of
a tracheostomy tube. Available tracheostomy tubes were tried and ill fitting as each
tube narrowed the patient’s stoma or abutted her distal granulation tissue. To custom
create a tracheostomy tube, we used a standard rib shearer to shorten a #6 uncuffed
tracheostomy tube by 2 cm. The edges were further smoothed and beveled using sand
paper and a diamond burr drill. The finished product was a wide diameter tube with
a custom length suited to our patient. Conclusions: Although
a simple solution, the use of a rib shearer provides a quick and feasible solution
to creating custom length tracheostomy tubes in situations where custom length
tubes are needed yet unavailable.