Tracheal nudging is often required during preparation for anterior cervical surgery in patients with cervical spondylosis. Because the surgeon needs to use a blunt-ended hook to pull the tracheoesophagus to the side to expose the cervical spine during anterior cervical surgery, the patient’s esophagus is often affected by the local stretching, which often leads to postoperative dysphagia, especially in patients with more than 3 segments of cervical spondylosis. Tracheal nudge training can help the surgeon to facilitate the exposure of the cervical spine, reduce the occurrence of postoperative dysphagia, and is beneficial for maintaining a stable heart rate and breathing during surgery. So how do you do tracheal nudge training? We usually start tracheal nudge training 4 days before surgery, twice a day, 15 nudges each time for 3 days. Patients with good mobility of their hands can nudge themselves, while patients with severe numbness of the hands or paralysis of the upper limbs usually have their family members do it instead. The practice is to push the thyroid cartilage from right to left with the fingers of the right thumb, just 1 cm across the midline of the neck. It can be divided into three specific steps, as demonstrated by Professor Shen below. Step 1: Stand on the right side of the patient and confirm the right edge of the thyroid cartilage. Step 2: Place the right thumb finger on the right edge of the thyroid cartilage and gently, slowly and gradually push the thyroid cartilage from the right side to the left side. The soft tissue around the tracheoesophageal sheath is relaxed by this step. Step 3: Once the soft tissues around the tracheoesophageal sheath are relaxed, tracheal nudge training can be performed, requiring the thyroid cartilage to be pushed from the right side to the left side and 1 cm above the midline of the neck.