title: Tracheal fenestration. An improved technique.
abstract: Tracheal fenestration consists of a skin-lined tracheocutaneous communication with two skin valves that provides rapid access to the tracheobronchial tree. The procedure was first described in 1956 but the operative technique is difficult, and results of the valvular stoma are complicated by poor healing and scar formation. For these reasons, I developed an improved technique with significant advantages over the original one. Certain physiologic considerations were discussed regarding the benefits of this operation. Tracheal fenestration has a sound basis in the treatment of respiratory insufficiency caused by chronic lung diseases with excessive secretion. It not only helps in the respiratory toilet of these patients but provides easy access for administration of oxygen and nebulized medications.
mesh_terms: D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D012131:Respiratory Insufficiency / Q000601:surgery; D014140:Tracheotomy / Q000379:methods*