Click on image to enlarge; advance with cursor over border

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

1. Clinical Background: Tracheomalacia status post previous standard tracheotomy (subsequently removed)
   1. Untreated OSAS; morbid obesity
   2. Diabetes
   3. Other cardiopulmonary comorbidities.
2. Findings on endoscopy and at time of tracheotomy
   1. Firm narrowing of trach 3.8 cm below vcs (upper aspect of previous tracheotomy)
   2. Large thyroid isthmus
3. 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