Airway management in surgical correction of severe kyphoscoliosis associated with tethered cord and multiple malformations: A method of tracheostomaplasty by partial resection of the cricoid cartilage

Abstract

In patients with factors leading to potentially difficult tracheostomy placement, including neck stiffness, obesity, cephalad displacement of the brachiocephalic artery, short neck, or thyroid disease, tracheostomaplasty by partial resection of the cricoid cartilage is a safe and effective method. The case of a 13-year-old boy with congenital kyphoscoliosis associated with a tethered cord and multiple malformations is reported herein. Tracheostomy was necessary for him to undergo extensive surgery, but failed to keep his airway secure as the tracheal tube readily dropped out of the tracheal lumen due to the spinal malformation. A tracheostoma was created by suturing the cricothyroid membrane and skin as a tracheostomaplasty by partial resection of the cricoid cartilage. After tracheostomaplasty, the patient successfully underwent detethering of the cord and corrective scoliosis surgery. After discharge, he had successful postoperative management of the tracheostomaplasty.

Keywords

• Congenital kyphoscoliosis
• Tracheostomaplasty
• Tracheostomy