Publication:

Trans-manubrial approach for the management of tracheal perforation secondary to blunt trauma

Traumatic tracheal injury is uncommon and mostly caused by blunt, penetrating, and iatrogenic injuries. Depending on the mechanism tracheal trauma may also be associated with injury to adjacent structures, including the cervical spine, cerebrovascular vessels, or digestive tract. These patterns are associated with high morbidity and mortality. Maintaining a high index of suspicion for tracheal injury is one of the most crucial factors for reducing mortality through early detection of tracheal trauma. Anterior mediastinal tracheostomy (AMT) is a complex operation typically performed in extensive cervicothoracic malignancy, stoma recurrence, or carcinoma of the cervical esophagus invading into cervical trachea but can be applies to traumatic injuries as well. In the clinical case presented, the patients’ prior surgical history and kyphotic anatomy necessitated a trans-manubrial approach for tracheostomy as opposed to the standard open or percutaneous approaches.