• J C Ryan and B McGuire.
• Department of Otolaryngology, Head and Neck Surgery, Ninewells Hospital, Dundee, Scotland, UK. jamie.ryan@healthotago.co.nz
• J Laryngol Otol. 2008 Oct 1;122(10):1096-9.

ObjectivesThis paper outlines our use of cricothyroid cannulation in those patients undergoing head and neck surgery in whom a 'difficult airway' is anticipated. Audit results are presented.Materials And MethodsProspective data collection for all patients undergoing cricothyroid cannulation for management of head and neck neoplasms, over a two-year period.ResultsThirty-nine cricothyroid cannulae were sited in 32 patients. All patients with laryngeal tumours underwent the procedure while awake, prior to the anticipated difficult intubation, and the cannulae were removed within six hours. Most cannulations performed under general anaesthetic were for anticipated 'dangerous extubations' in patients with oral cavity tumours, and these cannulae remained in place for 24 hours. Tracheostomy was possibly avoided in six patients. No complications were identified.ConclusionCricothyroid cannulation can be a simple, safe, reliable technique which is a useful adjunct in the management of patients with a potentially difficult airway.

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