A comparison of two emergency cricothyroidotomy kits in human cadavers.
BACKGROUND
We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate.


METHODS
Cricothyroidotomy was performed under fiberoptic control in 40 human cadavers embalmed according to Thiel's technique. The set chosen for use was randomized: new technique (NT) or ST. Duration of the procedure, success rates, and incidence of laryngeal injuries were compared. Traumatic lesions observed with the fiberoptic bronchoscope were anatomically confirmed after dissection.


RESULTS
The two groups had comparable epidemiological and anatomical records. Cricothyroidotomy was performed faster with the NT than with the ST (median 54 vs 71 s, P = 0.01). Failure rates were comparable between groups (4 vs 1, P = 0.34), and there were fewer major complications in the posterior tracheal wall with the ST (0 vs 8, P = 0.003). In the ST group, only minor punctiform lesions of the posterior trachea wall were observed in four cases.


CONCLUSIONS
In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.
Benkhadra
Mehdi
M
Division of Anatomy, University of Geneva, Geneva, Switzerland. m.benkhadra@wanadoo.fr
Lenfant
François
F
Nemetz
Wolfgang
W
Anderhuber
Friedrich
F
Feigl
Georg
G
Fasel
Jean
J
D000368:Aged; D000369:Aged, 80 and over; D020680:Bronchoscopes; D002102:Cadaver; D003413:Cricoid Cartilage / Q000601:surgery*; D004632:Emergency Medical Services; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D007830:Larynx / Q000293:injuries; D008297:Male; D011897:Random Allocation; D013957:Thyroid Cartilage / Q000601:surgery*; D013997:Time Factors; D014132:Trachea / Q000293:injuries; D017211:Treatment Failure; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology