HNO
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In terms of numbers, percutaneous dilatational tracheotomy (PDT) is the most important tracheotomy technique since it is applied in surgical and nonsurgical disciplines. Where correctly indicated, PDT is a fast, economical and easily reversible procedure. ⋯ In these cases scarring, wound infections and ambiguous anatomical structures can represent a surgical challenge. Where a long-term tracheotomy requirement is predicted, a surgical tracheostomy should be performed.
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Every blunt laryngeal trauma requires examination by an ENT physician and may necessitate observation for a number of hours. The literature shows a heterogeneous picture regarding airway management (tracheotomy vs. intubation). Extremely violence forces such as horse kicks require a tracheotomy, as demonstrated by case studies. ⋯ Intubation of the patient by the emergency physician would most probably have led to incorrect placement of the tube or complete displacement of larynx and trachea. In addition to securing a vital airway by tracheotomy, a timely reconstruction of the airways, where necessary by employing the temporary insertion of a tracheal stent, is the treatment of choice. The latter therapy should be applied within the first 6 hours following the accident.