Bronchoscopy and cricothyrotomy: results from cadavers embalmed with Thiel’s method compared to other embalming methods and living subjects

Abstract

Purpose: Cricothyrotomy and bronchoscopy were performed on cadavers embalmed according to Thiel’s method, and the results compared with findings from other types of cadavers and living subjects, to assess the suitability of such specimens for medical teaching and research.
 Methods: Blind cricothyrotomy was performed in 40 cadavers using two different devices (Cook and Portex sets) on each of 20 cadavers and the procedures were recorded by a monitoring fibreoptic bronchoscope placed in the larynx. Bronchoscopy was performed on another 22 cadavers. All procedures were videotaped and evaluated by board certified anatomists and anaesthetists. Tissue behaviour, ligament resistance, palpability of anatomical structures, mucosal colour and cadaver flexibility, especially during jaw thrust and tongue lift, were evaluated and qualitatively compared to conditions found in the living and to reports of studies using specimens embalmed with the classic formalin method. Where the procedures caused mucosal lesions, the damaged was assessed during subsequent dissection.
 Results: The cadavers were life-like in all criteria evaluated. Portex and Cook cricothyrotomy was feasible in all cases. Bronchoscopy was feasible in all cadavers without difficulty. Jaw thrust and tongue lift was never limited and lobar bronchi were always reached. Further advancement was limited in half of the cases by either the preservation liquid or the diameter of the segmental bronchi; in the remaining half, advancement into the smaller airways was limited only by their diameter.
 Conclusion: Cadavers fixed according to Thiel’s method are highly useable, life-like specimens for teaching and researching cricothyrotomy and bronchoscopy. The data obtained are transferable to the living, so research findings should be valid and teaching effective.

Variability in the projection level of the vertebra prominens: a cadaveric study

“…The study was carried out on 40 cadaveric bodies donated to Anatomical Science all formalin embalmed with Thiel's method [9,10]. Thiel's method is most suitable for such investigations due to its softness [11][12][13] with consecutive easy palpability of bony landmarks [14]. The bodies were donated before death after signed informed consent and were investigated under the approval and the strict rules of the Anatomical Donation Program of the Medical University of Graz and according to Austrian burial law.…”

Thiel's embalming method: review of the literature and our institute's experience

“…Many studies has been conducted on Thiel embalmed cadavers with clinical applications in reconstructive surgery, repair and reinforcement of tendons, and prophylaxis (3). The flexibility of the cadavers creates conditions for use in teaching anatomy to undergraduates, research, and surgical training techniques such as minimally invasive procedures, interventional radiology procedures, intubation, ventilation, ultrasound-guided regional anesthesia, suturing, biopsies, and endoscopies (3,14,15). The gold standard for a variety of basic and advanced procedures such as gallbladder, bariatric, antireflux, colorectal, and hernia surgery is the laparoscopic approach (16).…”