Percutaneous dilatational tracheostomy through paramedian technique and lateral approach in a patient with cervical esophagostomy-a case report.

BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure and established as first choice for securing the airway in critically ill patients needing prolonged mechanical ventilation. There are case reports of open tracheostomy through paramedian approach without complications. This case report presents a case of PDT through paramedian approach. CASE REPORT: An 18 year old female, case of firearm injury underwent cervical esophagostomy on the left side of neck approaching midline. So we perform PDT through paramedian technique and lateral approach safely with use of real time ultrasound and fiberoptic bronchoscope. DISCUSSION: PDT can be done through paramedian technique and lateral approach to trachea safely with help of ultrasound and fiberoptic bronchoscope in the conditions where midline approach is not feasible and unsafe.