• Mehdi Benkhadra, François Lenfant, Wolfgang Nemetz, Friedrich Anderhuber, Georg Feigl, and Jean Fasel.
• Division of Anatomy, University of Geneva, Geneva, Switzerland. m.benkhadra@wanadoo.fr
• Anesth. Analg. 2008 Jan 1;106(1):182-5, table of contents.

BackgroundWe compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate.MethodsCricothyroidotomy was performed under fiberoptic control in 40 human cadavers embalmed according to Thiel's technique. The set chosen for use was randomized: new technique (NT) or ST. Duration of the procedure, success rates, and incidence of laryngeal injuries were compared. Traumatic lesions observed with the fiberoptic bronchoscope were anatomically confirmed after dissection.ResultsThe two groups had comparable epidemiological and anatomical records. Cricothyroidotomy was performed faster with the NT than with the ST (median 54 vs 71 s, P = 0.01). Failure rates were comparable between groups (4 vs 1, P = 0.34), and there were fewer major complications in the posterior tracheal wall with the ST (0 vs 8, P = 0.003). In the ST group, only minor punctiform lesions of the posterior trachea wall were observed in four cases.ConclusionsIn this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.

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