耳鼻喉科：喉科学2.ppt

* * The second question I want to ask you is …… if the obstruction of the upper airway occur, what shall we do? Most of you would think of tracheotomy. But do you know …….. We can classify this measures as nonsurgical management and surgical management * It is a new emergency airway management device for patients requiring rapid airway control. It is a double lumen tube with an open trachea cannula and a blocked distal esophgeal end * Let’s discuss them one by one. Tracheotomy is the most important and primary surgical management. In emergency situations, cricothyroidotomy is considered the procedure of choice because it is fast and simple to perform and it requires very few instruments but it is more dangerous than tracheotomy. * In emergency situations, cricothyroidotomy is considered the procedure of choice because it is fast and simple to perform and it requires very few instruments. However,. Tracheotomy can also be performed urgently. So this procedure is used less and less. * Cricothyroidotomy is ?? technically more difficult, bloody, and dangerous compared to elective tracheotomy. It should also be avoided in children. Tracheotomy is now done more on an elective basis to protect the airway, better clean the airway and to provide more oxygen to the lungs. * Interest in percutaneous tracheotomy has increased recently. Controversy (dispute, arguement,debate) about it is the safety and efficiency of this procedure and standard of care The proponents, The opponents .potential complications because of the blind entry into the trachea. in this technique. This argument continues. * Tracheotomy is the most important and primary surgical management. * * * * * As we know, the trachea is surrounded by a lot of important anatomic structures. Such as ……. The thyroid isthmus crosses the trachea and the recurrent laryngeal nerve lies on each side of the trachea. The trachea get trough the mediastinum So it is very dangerous for us to perform the procedure.