A Case of Ankylosing Spondylitis with Cervical Spine Fracture and a Retropharyngeal Hematoma Requiring Cricoid Fenestration

Abstract

Retropharyngeal hematoma can induce dyspnea by causing upper airway obstruction. Therefore, early diagnosis and prompt securing of the airway, either by tracheal intubation or tracheostomy, are of importance. Tracheostomy is usually carried out between the 2nd and 4th tracheal ring. However, it is difficult to perform standard tracheostomy in patients with abnormalities of the cervical region, such as obesity, low-set larynx, neck stiffness, thyroid tumor, brachiocephalic meandering, or an unstable cervical spine. In 2007, Kano et al. reported “a newly developed surgical airway-opening technique (cricoid fenestration) using partial resection of the cricoid cartilage to form a stoma.”