Detailed Surgical Technique of Tracheal Fenestration, with a Report of Twenty-Six Cases

Abstract

Tracheal fenestration 1-5 is a new operative procedure for the treatment of chronic respiratory diseases. It is a skin-lined cervical tracheocutaneous communication equipped with two door-like skin valves at its external end. The valves can be opened at will for the purpose of tracheobronchial aspiration and medication, or self-aspiration and self-medication. When the valves are not held apart, the tracheocutaneous communication is airtight and leakproof; phonation and the cough mechanism remain normal. The purpose of this paper is to present the detailed surgical technique of tracheal fenestration, based on experience with 26 cases. Operative Technique A 4 in. long transverse skin incision is made over the lower anterior surface of the neck, about the level of the cricoid cartilage. This incision is then extended in such a way that one skin flap is outlined above, and one below, the level of the initial transverse incision. The base of each opposing