The extra-anatomical percutaneous access to the trachea knows two ways: as a life-saving emergency measure in an acute airway obstruction above the larynx, whereby ideally the cricothyroid ligament between the thyroid and cricoid cartilage is penetrated (cricothyrotomy).
As well as a usually elective procedure in intensive care medicine to enable long-term ventilation by means of an indwelling tube, which can thus bypass the nasal or oral cavity, pharynx, and larynx (puncture tracheotomy).
The tracheostoma created by puncture, probing with a guide wire, and gentle dilation (PDT) serves for the placement of a blockable tracheostomy tube made of different materials and corresponding care modalities. A variant of this procedure replaces the access via percutaneous puncture with surgical preparation.
Tracheotomy is one of the oldest surgical procedures ever.
Thus, medical historical literature already mentions it in the Rig Veda of Hinduism (1) from the 2nd millennium BC or in Galen (2 and 3).
In the first half of the 19th century, the procedure gained the status of a standardized procedure through the publications of Armand Trousseau (4) on his treatments of numerous children sick with diphtheria (5).
In statistical evaluations of the periprocedural complications of tracheotomy, figures are found in the wide range between 5 and 48 %, mostly without significant advantage for surgical preparation over the puncture method (6).
In a study from 2012, M. Pauliny and colleagues updated this comparison on 109 patients and found no statistical advantage of the more elaborate surgical approach over the puncture method, which is mostly performed outside an operating room, regarding postoperative bleeding, infection, and air leaks (pneumothorax, pneumomediastinum) (7).
The results corresponded to those of the work by Th. M. Treu and M. Knoch (8), who in 1997 apostrophized percutaneous dilatational tracheotomy as "a new procedure" and also reported 9 (inconsequential) mispunctures in 112 cases examined.
The most common acute consequences of a mispuncture for PDT are vascular in nature. A compilation on this as well as the case report of a severe non-vascular complication can be found in the article by Peter Gilbey from August 2012.
Undoubtedly also deserving mention is the depiction of the operation by Henri de Toulouse-Lautrec (9) from 1891 ("Opération de trachéotomie"), which shows none other than Docteur Jules Emile Péan at work; however, probably at an early preparatory stage of the “opération”: after all, he is looking deep into the patient's mouth.
The literature is inconsistent regarding the first description of the procedure commonly used today; however, the majority cite the article by P. Ciaglia from 1985 (10) and its long-term follow-up from 1992 (11).