Discussion
Tracheostomy related tracheal tear occurs infrequently and less commonly than intubation related tracheal tear. Mostly it is related to tracheostomy placement, using cuffed tubes and overinflation of the cuff or the tear directly follows traumatizing tracheostomy tube introducer insertion. The tear due to tracheostomy mostly located proximal to carina and distal to insertion of point of tracheostomy. Symptoms and complications of the tear may occur intraopertivly or postoperatively(5). Gold standard method for diagnosis will be established by flexible or rigid tracheobronchoscopy which helps in determining the site, size, extension of the tear and its location with respect to the carina that are essential to document. Imaging studies like CT scan which also helps in establishing the diagnosis of tear and some of it is complications such as pneumothorax, pneumonia, pneumomediastinum and mediastinitis. Treatment can be conservative for small uncomplicated wound in stable patient. For larger complicated tears and unstable patient surgical treatment is the gold standard.