Tracheostomy

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Abstract
DURING the past decade the value of tracheostomy, particularly as an aid in controlling and assisting respiratory ventilation using cuffed tubes, cannot be overestimated. With its widespread use complications and problems have arisen, as evidenced by more numerous reports of these in the literature. The four cases of tracheal stenosis occurring within a year on one surgical service reported in the Annals of Thoracic Surgery in January 1966,1 prompts a review of the procedure. In this latest documentation, animal experimentation confirmed the opinion that the pressure from an occluding cuff would cause stenosis at the opening into the trachea, and placement of the cuff at the distal end of the tube away from the operative site was advantageous. The fact that a No. 8 tracheostomy tube might be the principal factor in the development of stenosis in a small trachea was overlooked, for an oversized tube increases the trauma

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