Anterior approach for repair of an extensive iatrogenic tracheal tear.

© 2002 Association médicale canadienne T keys to successful treatment of tracheal tears after endotracheal intubation are early recognition, control of airway, antibiotic therapy and surgical repair. Surgical approaches to the repair of iatrogenic membranous tracheal injuries depend on the extent and location of the tear. Tears of the upper two-thirds can usually be repaired through a cervical incision. Lower tracheal or juxtacarinal tears can be approached through a right thoracotomy. Exposure for total or near-total membranous tears may be best obtained by median sternotomy and collar incision, with the repair performed through a longitudinal anterior tracheal incision. We have used this novel approach to such an extensive tear with success.