Bronchotomy

Bronchotomy is a surgical incision into the throat. Nowadays, such procedures are typically referred to more precisely by the place of incision (i.e. laryngotomy, thyrotomy and tracheotomy).

History

Asclepiades of Bithynia is credited with being the first person who proposed bronchotomy as a surgical procedure, though he never attempted to perform one. Aretaeus of Cappadocia thought the procedure dangerous even as a remedy for choking, since the resulting incision "would not heal, as being cartilaginous"; Caelius Aurelianus also rejected its usefulness.

Excerpts of otherwise lost writings by Antyllus, cited by Paul of Aegina, are the earliest to describe the technique and note the circumstances of its legitimate applicability:

When the inflammation lies chiefly about the throat, the chin, and the tonsils which cover the top of the windpipe, and the artery is unaffected, this experiment is very rational, to prevent the danger of suffocation. When we proceed to perform it, we must cut through some part of the windpipe, below the larynx, about the third or fourth ring; for to cut quite through would be dangerous. This place is the most commodious, because it is not covered with any flesh, and because it has no vessels near it. Therefore, bending the head of the patient backward, so that the windpipe may come more forward into view, we make a transverse section between two of the rings, so that in this case not the cartilage, but the membrane which incloses and unites the cartilages together, is divided. If the operator be a little fearful, he may first divide the skin, extended by a hook; then, proceeding to the windpipe, and separating the vessels, if any are in the way, he must make the incision.

References

Specific citations:

General references:

•  This article incorporates text from a publication now in the public domain: Chisholm, Hugh, ed. (1911). Encyclopædia Britannica (11th ed.). Cambridge University Press.