title: External light guidance for percutaneous dilatational tracheotomy.
abstract: BACKGROUND
  Percutaneous dilatational tracheotomy (PDT) is considered a safe technique; however, there is still room for improvement. We present our initial experience with an external white light guide to position the endotracheal tube and guide needle placement during PDT.
  
  
  METHODS
  This is a retrospective series of 15 consecutive patients undergoing external light-guided PDT. A white light source was placed on the anterior trachea wall externally and the transmitted light was identified in the tracheal lumen with a bronchoscopic to predict the needle entrance point.
  
  
  RESULTS
  The transmitted light was rapidly identified in all 15 patients, facilitated endotracheal tube tip placement in the subglottis in approximately 10 seconds in 13 of 15 patients, and predicted needle penetration into the trachea within 1 to 2 mm of the external light in all patients.
  
  
  CONCLUSIONS
  External light guidance facilitates rapid, accurate placement of the needle through the tracheal wall and can reduce surgeon anxiety, especially in teaching situations.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA. ielsayed@ohns.ucsf.edu
authors.forename: Ivan H
authors.initials: IH
authors.lastname: El-Sayed
authors.forename: James E
authors.initials: JE
authors.lastname: Ho
authors.forename: David W
authors.initials: DW
authors.lastname: Eisele
mesh_terms: D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods; D016292:Procedural Sedation; D004106:Dilatation / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000379:methods; D008027:Light; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012494:Sampling Studies; D014140:Tracheotomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome