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return to: Tracheotomy - Tracheostomy or Four-flap Epithelial Lined Tracheotomy
Passy-Muir Valve (PMV 005) and Provox XtraBase baseplate following four flap epithelial lined tracheotomy
with thyroid isthmusectomy and anterior cervical lipectomy
- Clinical Background: Tracheomalacia status post previous standard tracheotomy (subsequently removed)
- Untreated OSAS; morbid obesity
- Diabetes
- Other cardiopulmonary comorbidities.
- Findings on endoscopy and at time of tracheotomy
- Firm narrowing of trach 3.8 cm below vcs (upper aspect of previous tracheotomy)
- Large thyroid isthmus
- Note an alternative is to use an obturator fashioned by an anaplastologist or dental prosthedontist as per Harley (1971) and Friedberg (1974)
References
Friedberg SA, Azem K and Wallner LJ: Tracheostome Maintenance by Obturator for Prolonged or Future Need Annals of Otology, Rhinology & Laryngology 83:1974 pp 520-524
Harley WT, Rothwell US: Fabrication of tracheostomy obturators. J Prosthet Dent 25:679-683, 1971