Tracheotomy

The trachea is located in the middle of the neck, and its upper section is shallower, about 1.5 to 2 cm from the skin; the lower section gradually deepens, and it is about 4 to 4.5 cm from the skin at the upper edge of the sternum. The front of the trachea is covered by skin, subcutaneous tissue, superficial fascia, and platysma. Between the superficial fascia and the platysma, many small veins (anterior jugular plexus) converge into the anterior jugular vein. The deep layer of the platysma is a deep layer of deep fascia that surrounds the anterior cervical muscles on both sides and forms a white fascia line at the midline. Behind the deep layer of the deep fascia is the deep fascia middle layer before the trachea and the trachea. The anterior tracheal fascia is attached to the anterior wall of the trachea. The thyroid gland is located on both sides of the trachea, and the thyroid isthmus is located in front of the third and fourth tracheal rings. It is surrounded by the anterior fascia of the trachea. The thyroid isthmus should be pushed up or cut off before surgery. The inferior thyroid gland, veins, and thyroid venous plexus are located inward of both sides of the trachea, and the main neck blood vessels are located outward. Therefore, when performing tracheotomy, the incision must be in the neck safety triangle (the upper two corners of the triangle) At the junction of circular cartilage and sternocleidomastoid muscle, the lower corner is at the midpoint of the sternal notch).