Abstract
Purpose
To understand the anatomical relationships of the Esophageal-Tracheal Combitube (ETC) with the larynx, pharynx, esophagus and trachea.
Methods
An extensive dissection of the neck and thorax of a 70-yr-old Caucasian male cadaver was done to expose the larynx, pharynx, trachea and esophagus. The ETC was inserted following the manufacturer’s recommendations. Effects of the ETC on the surrounding structures were observed with the ETC first inserted in the esophagus and then, in the trachea.
Results
When inserted in the esophagus, the ETC produced marked bulging of the anterior wall of the esophagus and anterior displacement (4.5 cm) of the trachea. Inflation of the distal cuff of the ETC produced distension of the esophagus. When inserted in the trachea, the ETC also caused anterior protrusion.
Conclusion
Protusion of the anterior wall of the esophagus and distension resulting from inflation of the distal cuff could lead to esophageal injuries. These observations may explain the previously reported complications associated with the use of the ETC.
Résumé
Objectif
Comprendre les relations anatomiques entre le Combitube et le larynx, le pharynx, l’oesophage et la trachée.
Méthode
Une importante dissection du cou et du thorax a été pratiquée sur le cadavre d’un homme de 70 ans de race blanche afin d’exposer le larynx, le pharynx, la trachée et l’œsophage. Une fois le Combitube inséré selon les directives du manufacturier, on en a observé les effets sur les structures environnantes, le tube étant d’abord dans l’œsophage, puis dans la trachée.
Résultats
Quand le Combitube était dans l’œsophage, il a produit un bombement marqué de la paroi antérieure de l’œsophage et un déplacement antérieur de la trachée (4,5 cm). Le gonflement du ballonnet distal du Combitube a produit une distension de l’œsophage. Inséré dans la trachée, le Combitube a aussi causé une protrusion antérieure.
Conclusion
La protrusion de la paroi antérieure de l’œsophage et la distension qui résultent du gonflement du ballonnet distal peuvent provoquer des lésions à l’œsophage. Ces observations peuvent expliquer les complications déjà connues, associées à l’usage du Combitude.
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An erratum to this article is available at http://dx.doi.org/10.1007/BF03013965.
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Vézina, D., Trépanier, C.A., Lessard, M.R. et al. Esophageal and tracheal distortion by the Esophageal-Tracheal Combitube: a cadaver study. Can J Anaesth 46, 393–397 (1999). https://doi.org/10.1007/BF03013236
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DOI: https://doi.org/10.1007/BF03013236