Esophageal and tracheal distortion by the Esophageal-Tracheal Combitube: a cadaver study.
OBJECTIVE
To understand the anatomical relationships of the Esophageal-Tracheal Combitube (ETC) with the larynx, pharynx, esophagus and trachea.


METHODS
An extensive dissection of the neck and thorax of a 70-yr-old caucasian male cadaver was done to expose the larynx, pharynx, trachea and esophagus. The ETC was inserted following the manufacturer's recommendations. Effects of the ETC on the surrounding structures were observed with the ETC first inserted in the esophagus and then, in the trachea.


RESULTS
When inserted in the esophagus, the ETC produced marked bulging of the anterior wall of the esophagus and anterior displacement (4.5 cm) of the trachea. Inflation of the distal cuff of the ETC produced distension of the esophagus. When inserted in the trachea, the ETC also caused anterior protrusion.


CONCLUSIONS
Protrusion of the anterior wall of the esophagus and distension resulting from inflation of the distal cuff could lead to esophageal injuries. These observations may explain the previously reported complications associated with the use of the ETC.
Vézina
D
D
Département d'anesthésie, Centre hospitalier affilié universitaire de Québec, P. Québec, Canada. vezd@quebectel.com
Trépanier
C A
CA
Lessard
M R
MR
Bussières
J
J
D000368:Aged; D002102:Cadaver; D004867:Equipment Design; D004947:Esophagus / Q000033:anatomy & histology* / Q000293:injuries; D006801:Humans; D007440:Intubation / Q000009:adverse effects / Q000295:instrumentation; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D007830:Larynx / Q000033:anatomy & histology; D008297:Male; D010614:Pharynx / Q000033:anatomy & histology; D013499:Surface Properties; D014132:Trachea / Q000033:anatomy & histology*