PMC8131148_01
Simultaneous use of two endotracheal tubes. (a) The emergently placed ETT through the self-inflicted neck wound with the cuff inflated (white cuff) is used to ventilate the patient while a second ETT is passed from the oropharynx using a fiberoptic scope as a smart stylet (black dotted line in the tube). (b) The tracheal ETT cuff is deflated (black cuff) while the oral ETT is advanced over the fiberoptic scope. (c) The oral ETT cuff is inflated (white cuff) while the tracheal ETT is withdrawn and eventually taken out through the wound in the neck. A white cuff indicates an inflated cuff; a black cuff indicates a deflated cuff.
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fig1
Then, the 8.0 ETT preloaded on the FOB was passed over the FOB beyond the level of the tracheal injury while leaving the first ETT in place (Figure 1).
Tracheal injury.
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fig2
Subsequent surgical exploration revealed that all structures adjacent to the tracheal injury including vascular structures were intact (Figure 2).