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December 1959

Detailed Surgical Technique of Tracheal Fenestration, with a Report of Twenty-Six Cases

Author Affiliations

New York
From the New York Medical Col lege-Metropolitan Medical Center, and St. Anthony's Hospital, Woodhaven, Long Island, N.Y.

AMA Arch Surg. 1959;79(6):875-888. doi:10.1001/archsurg.1959.04320120017003

Tracheal fenestration1-5 is a new operative procedure for the treatment of chronic respiratory diseases. It is a skin-lined cervical tracheocutaneous communication equipped with two door-like skin valves at its external end. The valves can be opened at will for the purpose of tracheobronchial aspiration and medication, or self-aspiration and self-medication. When the valves are not held apart, the tracheocutaneous communication is airtight and leakproof; phonation and the cough mechanism remain normal. The purpose of this paper is to present the detailed surgical technique of tracheal fenestration, based on experience with 26 cases.

Operative Technique  A 4 in. long transverse skin incision is made over the lower anterior surface of the neck, about the level of the cricoid cartilage. This incision is then extended in such a way that one skin flap is outlined above, and one below, the level of the initial transverse incision. The base of each opposing

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