Postintubation tracheal tear repair by cervicotomy and longitudinal tracheotomy

Background. Membranous tracheal lacerations are a serious complication of endotracheal intubation. Smaller tears are often better managed with a conservative treatment. Larger ruptures, especially when associated with important manifestations, need an early surgical repair. Methods. In the last 3 years, three female patients with a posterior tracheal wall laceration, related to endotracheal intubation, underwent surgical procedure in our institution. All tracheal tears were repaired with a running suture through a small cervical collar incision and longitudinal tracheotomy. Results. All surgical procedures were effective and lasted less than 1 hour. Patients were discharged on average after 5 days. Endoscopic follow-up showed a perfect repair of the tear without signs of tracheal stenosis. Conclusions. This is a reliable, quick, and safe approach to a rare but insidious complication of general anesthesia. It avoids lateral and posterior dissection of the trachea, reducing the risk of a recurrent laryngeal nerve injury. (C) 2000 by The Society of Thoracic Surgeons.