To the Editor.—We are reporting the occurrence of an intraoperative fire that occurred during a routine tracheostomy performed under local anesthesia. The patient had an inoperable lingual carcinoma and was to undergo a tracheostomy to secure her airway. The patient wore neither perfume nor hairspray on the day of surgery. A malodorous smell that emanated from the oropharynx was attributed to the necrotic tumor.
After cleansing the anterior aspect of the neck with an alcohol pad, 1% lidocaine with 1:100000 epinephrine solution was infiltrated. The patient was then routinely prepared with betadine scrub and solution followed by draping with four cotton towels. A towel was placed loosely over the patient's face. A paper drape was placed over the patient's body and extended cranially along both sides of the head. A single cloth towel remained exposed at the superior aspect of the operative field. Supplemental oxygen was provided from the