Esophageal and tracheal distortion by the Esophageal-Tracheal Combitube: Acadaver study

Purpose: To understand the anatomical relationships of the Esophageal-Trach eal Combitube (ETC) with the larynx, pharynx, esophagus and trachea. Methods: An extensive dissection of the neck and thorax of a 70-yr-old cauc asian male cadaver was done to expose the larynx, pharynx, trachea and esop hagus. The FTC was inserted following the manufacturer's recommendations. E ffects of the ETC on the surrounding structures were observed with the FTC first inserted in the esophagus and then, in the trachea. Results: When inserted in the esophagus, the ETC produced marked bulging of the anterior wall of the esophagus and anterior displacement (4.5 cm) of t he trachea. Inflation of the distal cuff of the FTC produced distension of the esophagus, When inserted in the trachea, the ETC also caused anterior p rotrusion, Conclusion: Protusion of the anterior wall of the esophagus and distension resulting from inflation of the distal cuff could lead to esophageal injuri es, These observations may explain the previously reported complications as sociated with the use of the FTC.