The complication rate after emergency tracheostomy is two to five times greater than after elective procedures. One of the main causes of the high risk of complications in emergency tracheostomy appears to be the amount of time required to open the trachea. Therefore, simple and fast procedures are mandatory. We have developed a new procedure as follows: A horizontal skin incision is performed. Strap muscles are dissected and retracted laterally. A transverse cut between tracheal rings below the thyroid isthmus is performed up to membranous portion of the trachea. The cut ends of the trachea remain open naturally because of the elasticity of the trachea. Skin and tracheal cut-ends are then joined by interrupted sutures.We have used this procedure during the past three years and have not experienced any major complications. This demonstrates the clear advantage and the more physiological nature of the procedure over various other incisions of the tracheal wall.

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KyushuDentalSociety itILIvlcaftXt,51 (6):761-767,1997. N fiZll JfifiI iPL.EB2F., Vi St-g-6 bkiiifiiJ t LE]}iL4as Zil cD vaH(rutmpkflwaNtF4tsitst ,E.E[.")II es as･=[d: M .E.ii. :IL･LLI-F if eA ts ee JR A･N ev EJII Z･1] J[l as ee wh it n"Hcaillt7nwaptFL\ee2ncU (2ff: tcde taXN) ilZat 9 lli 10 Jl 24 Heewa Kyushu Dental Collegc, Kitakyushu, Japan In the present study, we investigated the clinical and histopathological effects of CP therapy by combined use of cisplatin (CDDP 50 mg/m2) or carboplatin (CBDCA 300mg/m2) and Peplomycin (PEP 5mg/day) for 24 cases with oral squamous cell carcinorna. The effect of treatment and associated complications were as follows: 1. Complete response (CR) was achieved in 8 and partial response (PR) in 13 of the 24 cases. The overall clinical response rate was 87.5%. The histological response rate was 62.5 %. 2. The clinical effects did not always agree with the histopathological effects. There were discrepancies between clinical and histopathological effects, especially in PR determined by clinical findings. 3. The principal adverse reaction was gastrointestinal disturbances, but symptorns were able to be controlled. Signs of hematologic toxicity and renal disturbances were mild and did not preclude the continuance of therapy. 4. The results of this study indicated that neo-adjuvant chemotherapy with CDDP and PEP was highly effective for the local control of oral squamous cell carcinoma.

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