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In vitro study investigating post neck surgery haematoma airway obstruction

Published online by Cambridge University Press:  02 September 2008

E R M Carr*
Affiliation:
Department of Ear, Nose & Throat Surgery, Derbyshire Royal Infirmary, Derby, UK
E Benjamin
Affiliation:
Department of Ear, Nose & Throat Surgery, Charing Cross Hospital, London, UK
*
Address for correspondence: Mr ERM Carr, Amber Mill Furniture Cottage, Oakerthorpe DE55 7LL, UK. Fax: 01899 830 482 E-mail: esmond@doctors.org.uk

Abstract

Objectives:

To investigate whether the possible pressure produced by a haematoma in the neck would be sufficient to directly compress the trachea to the point of airway obstruction.

Study design:

In vitro study.

Methods:

Varying pressures were applied over the second and third cartilaginous rings of 10 pig tracheas in vitro and the anterior–posterior compression was measured.

Results:

At pressures of 257 mmHg, equivalent to the maximum possible pressure in the neck (i.e. systolic blood pressure), there was an average compression of 20.8 per cent of the original anterior–posterior tracheal diameter.

Conclusions:

This study suggests that the pressures in haematomas observed after neck surgery would not be sufficient to cause airway obstruction due to direct pressure on the trachea. Therefore, the most likely cause of airway obstruction would be supraglottic oedema secondary to venous obstruction.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented as a poster at the Joint ENT UK/Royal Society of Medicine meeting, 6–7 September 2007, London, UK.

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