Navigating a challenging airway: An ultrasound-guided approach to urgent tracheostomy.

Objectives: Airway compromise in neck cancer patients with distorted anatomy has been a challenge for head and neck surgeons. To the best of our knowledge, the use of ultrasound has not been reported as an adjunct prior to an awake urgent tracheostomy in these types of patients. Our main objective is to provide an additional tool for identification of vital neck structures in preparation for an awake tracheostomy.

Data Sources: Literature review REVIEW METHODS: This literature review was performed through the following data sources: PubMed and Cochrane Library.

Conclusions: Ultrasound is a cost-effective method to provide safe identification of vital structures in patients with distorted neck anatomy who requires an urgent awake tracheostomy.

Implications For Practice: This article highlights the importance of ultrasound-guided tracheostomy for identification of anatomical landmarks in patients with distorted neck anatomy. We also propose a safe, reliable, and logarithmic approach for successful awake tracheostomy in these patients' using ultrasonography. We firmly believe that the ultrasound should be part of the armamentarium of all head and neck surgeon. By taking advantage of the advances in technology, the morbidity and mortality of establishing a secure airway in the distorted neck anatomy can be decreased.