• Tracheotomy in the morbidly obese patient (weight more than 130 kg) is a difficult procedure. Because of the thickness of the anterior part of the neck and the redundant chin, most commercially available cannulas are inadequate. A custom-made tube is designed by splitting an endotracheal tube along its longitudinal axis and bending the split sides into a T shape. A modification of the available cannulas is proposed to make them suitable for the morbidly obese patient: they should be longer and straighter toward the external opening and an optional extension should be provided to bypass the double chin.
(Arch Otolaryngol Head Neck Surg 1987;113:556-558)
Ghorayeb BY. Tracheotomy in the Morbidly Obese Patient. Arch Otolaryngol Head Neck Surg. 1987;113(5):556–558. doi:10.1001/archotol.1987.01860050102026
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