Biomechanical Evaluation of Tracheal Needle Puncture Forces: Comparative Analysis of Annular Ligaments and Tracheal Cartilage.

Abstract

Percutaneous tracheotomies (PCT) are a commonly performed surgical procedures, involving the opening of the airways through an incision or puncture of the tracheal wall. Severe clinical symptoms may arise as a result of tracheotomy complications or due to the alteration of the airways biomechanical properties/structures. The causes and mechanisms underlaying the development of these post tracheotomy complications remains unknown. Here, we report on the biomechanical characteristics of tracheal punctures using the porcine tracheal model to simulate the forces involved in accessing airways during PCT at varying angular approaches. As many procedures involving passing a needle into the trachea are done without direct visualization of the tracheal wall, there are concerns that needle punctures through the cartilaginous rings as compared to the space between them may result in fractured cartilage and airway complications. We report a difference in puncture force between piercing the cartilage and the annular ligaments and observe that the angle of puncture does not significantly alter the puncture forces. The data collected in this study can guide the design of relevant biomechanical feedback during PCT and ultimately help refine and optimize PCT.