Tracheal fenestration is an operation to provide a permanent access to the deeper air-ways. The stoma can be kept open or closed at will. Its use is here proposed as a new method of treatment in advanced pulmonary insufficiency. The four patients whose cases are described were approaching terminal hypoxia as a result of destructive pulmonary disease. Tracheal fenestration made it possible to remove mucopulmonary secretions by aspiration. The patient gradually learns to do this himself. The immediate relief experienced by the patient after aspiration, and the striking change for the better in the course of the disease in these four cases, indicate that the advantages of tracheal fenestration need to be explored further.
Mayer E, Blazsik CF, Rappaport I. TREATMENT OF PULMONARY INSUFFICIENCY BY TRACHEAL FENESTRATION: PRELIMINARY REPORT. JAMA. 1958;167(6):696–701. doi:10.1001/jama.1958.02990230022003
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