The Laryngoscope
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Tracheotomy is a commonly performed surgical technique used for long-term mechanical ventilation, upper airway obstruction, need for pulmonary toilet, and as an adjunct to surgery where ventilation is anticipated. Urgent tracheotomy may be performed when difficulty is encountered during an elective tracheotomy, or when cricothyroidotomy is impossible or contraindicated due to distorted anatomy or laryngeal obstruction. ⋯ We have used the Eisele tracheotomy punch (Pilling, Teleflex Medical, Research Triangle Park, NC) for all tracheotomies, both elective and urgent. In this report we describe five illustrative cases in which the tracheotomy punch was used successfully in the urgent setting to ensure rapid airway access.
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Treatment and management of tracheal defects remain challenging in head and neck surgery. Various reconstruction techniques have been used, with no consensus on the best approach. The purpose of this study was to explore a novel strategy to fabricate tissue-engineered trachea by using fibrin/hyaluronic acid (HA) composite gel and evaluate the feasibility of creating tracheal cartilage. ⋯ The tracheal luminal contour and functional epithelial regeneration without graft rejection and inflammation were observed after repair of a tracheal resection using allogeneic implants with chondrocytes cultured with fibrin/HA.