• Fausto Ferraro, Lucia Marullo, Anna d'Elia, and Giuseppe Izzo.
• Department of Anaesthesiology, Surgical and Emergency Science, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy.
• Indian J Anaesth. 2014 Mar 1;58(2):190-2.

AbstractThere is no optimal tracheostomy (TS) technique, proved to be the best. For this reason, operators' skills, clinical anatomical and physio-pathological features of the patient should be considered as discriminating factors in the choice of percutaneous dilation tracheostomy (PDT) technique. This article includes reports of three cases of PDT: In the first case distance between jugular notch and the first tracheal ring was too long, the second case involving a patient with mild ectasia of the ascending aorta and aortic regurgitation with De Musset's sign with great risk of perioperative bleeding and a third case, of tracheomalacia with inflammatory stenosis at the 4(th) tracheal ring. All together, this case series describes how decisions were made by an experienced staff, in which the patient characteristics were assessed and techniques best suited for each case were implemented.

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