ABSTRACT
A form of tracheotomy was first depicted on Egyptian hieroglyphs dating back to 3600 BC and was later described by the Greek Homerus of Byzantium and Hippocrates. Understanding the surface anatomy of the trachea is essential when performing tracheostomy. The blood supply to the cervical trachea is segmental and is derived from branches of the inferior thyroid artery that form a longitudinal plexus running laterally alongside the cartilaginous-membranous junction. Contraindications to tracheostomy include any medical condition contraindicating surgery such as uncontrolled coagulopathy or hemodynamic instability. There are two surgical options for creation of a tracheostomy: open and percutaneous. The most commonly used percutaneous tracheostomy system is the one-step dilational method using the commercially available Ciaglia Blue Rhino kit. Numerous randomized studies and meta-analyses have been performed to compare open and percutaneous tracheostomy. For the open procedure, it usually takes about 4 or 5 days while the percutaneous technique may require up to 2 weeks to mature.
