摘要：Percutaneous tracheostomy is a routine procedure in intensive care
units. In cases of very low position of the larynx, cervical spine
deformation, morbid obesity, or neck tumor, performance of the
classic tracheostomy is inapplicable. Retrosternal approach to
tracheostomy in such 20 patients is herein reported. After
preoperative neck computerized tomography to define the neck
anatomy, a small suprasternal incision followed by a short
retrosternal tissue dissection to expose the trachea was done; the
trachea was then catheterized at the level of the 2nd ring in the
usual tracheostomy manner. The immediate and late (≥6 months) outcomes were similar to that of the standard tracheostomy. Thus,
percutaneous retrosternal tracheostomy is safe in patients with
abnormal positioning of the trachea or neck constitution. It is a
bedside applicable technique, that, however, requires caution to
avoid hazardous vascular complications.
