title: Successful percutaneous tracheostomy via puncture through the thyroid isthmus.
abstract: Tracheostomy is one of the most frequently performed procedures in intensive care units. Bedside percutaneous tracheostomy has become an increasingly popular option to standard open tracheostomy. Several contraindications for percutaneous tracheostomy, including an enlarged thyroid isthmus, have been described. However, as experience with this technique has increased, most of the described contraindications appear to be relative rather than absolute, provided the procedure is performed by an experienced practitioner. Herein we present a case of an unavoidable direct puncture of the thyroid isthmus during a percutaneous tracheostomy. The procedure was performed smoothly, and no complications occurred.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital Taipei, Taiwan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Duann
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital Taipei, Taiwan ; Department of Surgery, National Yang-Ming University Hospital Yilan, Taiwan.
authors.forename: Min-Shiau
authors.initials: MS
authors.lastname: Hsieh
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital Taipei, Taiwan.
authors.forename: Pin-Tarng
authors.initials: PT
authors.lastname: Chen
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital Taipei, Taiwan.
authors.forename: Hsiao-Ping
authors.initials: HP
authors.lastname: Chou
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital Taipei, Taiwan ; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University Taipei, Taiwan.
authors.forename: Chien-Sheng
authors.initials: CS
authors.lastname: Huang
keywords: Percutaneous tracheostomy; thyroid isthmus