Elective cricothyroidotomy: a clinical and histopathological study.

Elective cricothyroidotomy was carried out on 61 adult patients in the ICU between June 1977 and October 1980. This procedure replaced elective tracheotomy in those patients who were judged to require respirator treatment for a period longer than 72 h. Twenty-six of the patients were examined by the ENT department. Of these, 19 were bronchoscoped more than 3 months after the cricothyroidotomy. Autopsies were carried out on 25 of the 30 patients who died. Histology of the larynx was available in 20 of the cases; in eight of these, a slight inflammation of the perichondrium was found and in two cases, the cartilage of the larynx was more seriously affected. Complications were few and mild. No damage to the vocal cords due to cricothyroidotomy was detected, and there have been no cases of stenosis in the larynx or trachea. Contraindications to cricothyroidotomy are endotracheal intubation for a period longer than 72 h, respiratory difficulties after previous endotracheal intubation, and acute infections of the larynx. Cricothyroidotomy is faster and much easier than tracheotomy. The authors believe that every doctor who works in intensive care should be able to carry out this procedure.