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Utilizing the principle of lower-deck ventilation of ships, I successfully prevented aspiration by suturing a tapering tube in the trachea to prevent aspiration during and after laryngectomy in two cases, and, encouraged by the interest shown by several surgeons, I am passing on the idea. Briefly, the method is as follows:
The tapering end is cut from a Valentine irrigating tube. The larynx and upper part of the trachea are skeletonized, local anesthesia being used, and the moment the trachea is severed, the smaller end of the flexible tube is snugly fitted into it and secured by two heavy sutures, which are passed from the skin through the trachea and tube and tied over lead buttons. These sutures are not disturbed until healing is completed.
If desired, it is a simple matter at this point to connect this tube with the rigid tube of a standard gas apparatus and proceed
IRVINE RS. USE OF A TAPERING TUBE SUTURED IN THE TRACHEA TO PREVENT ASPIRATION DURING AND AFTER LARYNGECTOMY. Arch Otolaryngol. 1934;19(1):69. doi:10.1001/archotol.1934.03790010076009
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