Cricoid Fenestration : A Novel Surgical Airway–opening Technique at the Larynx using Partial Resection of the Cricoid Cartilage

Abstract

In 2007, we reported a newly-developed surgical airway-opening technique（cricoid fenestration）using a par-tial resection of the cricoid cartilage to form a stoma. From 2006 to 2014, a total of 57 cricoid fenestration pro-cedures were performed at our hospital. The reasons for surgery included cervical disturbances such as low-set larynx, obesity, short neck, thyroid tumor, cervical abscess, and tortuous brachiocephalic and common carotid artery. Surgeries were also performed in high-risk patients who required long-term airway management, he-mostasis, and urgent airway establishment. In this study, only one patient developed subcutaneous emphysema as an intra-or postoperative complication. Cricoid fenestration enables us to easily create a stoma at a higher level of the cricoid cartilage without transecting the thyroid gland. In addition, this technique can quickly establish a controlled airway with a low risk of intraoperative bleeding. Finally, long-term airway management can be performed easily using this technique without tube-related complications including scarring or stenosis, despite the resection of the cricoid cartilage. Cricoid fenestration is therefore considered to be a safe and effective surgical airway-opening technique.