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Fig. 2 | Surgical Case Reports

Fig. 2

From: Anterior mediastinal tracheostomy for severe tracheal stenosis in a child with severe motor and intellectual disabilities: a case report

Fig. 2Fig. 2

Intraoperative photographs. a The initial transverse incision following the clavicular line with the existing tracheal stoma as the center point. b Exposing the bony chest wall. Dashed lines indicate the clavicle, sternum, and rib dissection lines. c The bony chest wall is resected. d The trachea is repositioned to the right side of the ascending aorta and innominate artery. e The lower incision is made from the right to the left anterior axillary lines beneath the breasts (red arrowheads) to create the bipedicle anterior cutaneous flap. The flap is moved upward (blue arrow). Dashed lines indicate the skin incision lines. f The new tracheal stoma is created at a point in the midline (red arrowheads). A, innominate artery; Ao, aorta; B, body of sternum; C, clavicle; M, manubrium of sternum; PA, pulmonary artery; R1, first rib; R2, second rib; R3, third rib; T, trachea; V, innominate vein

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