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What is High tracheostomy is done in: and explain in detail?
Ans. b. Laryngeal carcinomaRef: Diseases of Ear, Nose and Throat by Dhingra; 7th Ed Page No- 359 and Logan Turners Disease of the Nose, Throat and Ear 11th Ed; Page No- 569A high tracheostomy is done above the level of thyroid isthmus i.e. above 2nd tracheal cartilage.It can cause perichondritis of cricoid and subglottic stenosis, so it is avoided always; however in cases of Ca larynx total larynx will be removed and fresh tracheostomy made in clean area. So to preserve the site for permanent tracheostomy high tracheostomy is done.The only indication of high tracheostomy (i.e. tracheostomy at the 1st tracheal ring) is carcinoma of larynx.In laryngomalacia the management is reassurance. Rarely supraglottoplasty is required but not tracheostomy.In vocal cord palsy, it is done at tracheal rings 2 and 3 or 3 and 4.In subglottic stenosis, low tracheostomy is done.