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Hazards

Authoring team

A tracheostomy has important hazards, mainly haemorrhage as a result of failure to appreciate variable regional anatomy inferior to the thyroid gland:

  • inferior thyroid veins: form plexus anterior to the trachea and descend inferiorly
  • thyroid ima artery: present in 10% of population and ascends to the inferior margin of thyroid isthums on anterior surface of trachea
  • children:
    • superiorly-lying structures:
      • vessels: left brachiocephalic vein and confluence of veins can lie anterior to trachea within the root of the neck
      • thymus: covers a similar region before it regresses
    • trachea has a weak wall and is mobile; this makes the posteriorly-positioned oesophagus prone to damage when incising

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