Although crycothyroidotomy is often used to obtain an airway in treating patients with trauma or those in whom endotracheal intubation is impossible, we have used this procedure for two patients with respiratory failure due to head and neck cancer, with favorable outcomes. Case 1 involved a 59-year-old man who developed respiratory failure due to pulmonary aspiration caused by abrupt onset of massive bleeding from a locally recurred lesion of pharyngeal cancer. Endotracheal intubation was done. Since the cervical lymph node metastasis had invaded from the anterior cervical region to the caudal side skin of the cricothyroid ligament, tracheotomy was considered to be hazardous. Accordingly cricothyroidotomy was performed. After discharge, he spent times at home until his death. Case 2 involved a 70-year-old man who developed respiratory failure because undifferentiated thyroid cancer had invaded the trachea. He had to be managed by transnasal endotracheal intubation for artificial respiration under sedation. We performed crycothyroidotomy to escape from the artificial respiration. We aimed at home care, however, his cachexia gradually progressed and he died in our hospital.
In instances in which we have lost the time of tracheotomy like our cases, crycothyroidotomy can be performed as a palliative therapy that might serve to stabilize respiratory status.