Endoscopic technique to mark the site of tracheal stenosis for resection

2007 ◽  
Vol 121 (8) ◽  
pp. 790-793 ◽  
Author(s):  
G Lichtenberger ◽  
C Sittel ◽  
A L Merati ◽  
Á Reményi
Keyword(s):  
Tracheal Stenosis ◽  
Tracheal Resection ◽  
Open Approach ◽  
Laryngotracheal Stenosis ◽  
Reconstructive Procedure ◽  
Additional Time ◽  
Reliable Technique ◽  
Diseased Segment ◽  
Inside Out ◽  
Stenotic Segment

AbstractBackground:It is difficult to precisely localise the extent of the diseased segment on the external aspect of a stenotic trachea. A technique has been developed of marking the upper margin of stenosis, in order to open the airway at the appropriate level during segmental resection.Materials and methods:Prior to the open reconstructive procedure, the stenosis is visualised using microlaryngoscopy. An endo-extraluminal technique is used to drive a suture from inside out through the skin; this then serves to mark the exact top margin of the stenotic segment. This suture serves as a guide for the surgeon during the open approach to tracheal resection.Results:This technique was performed in 16 cases, and allowed precise localisation of the stenosis in each case.Conclusion:Transcutaneous localisation of laryngotracheal stenosis, using the Lichtenberger device, is an easy and reliable technique requiring a minimum of additional time.

Novel use of Coblation technology in an unusual congenital tracheal stenosis

2013 ◽  
Vol 128 (S1) ◽  
pp. S55-S58 ◽  
Author(s):  
G Sim ◽  
S Vijayasekaran
Keyword(s):  
Minimally Invasive ◽  
Tracheal Stenosis ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Late Presentation ◽  
Tracheal Resection ◽  
Congenital Tracheal Stenosis ◽  
Invasive Treatment ◽  
The Individual ◽  
Stenotic Segment

AbstractBackground:We report the case of an unusual late presentation of congenital tracheal stenosis in a 13-year-old boy. He was treated with minimally invasive Coblation resection of the stenotic segment, avoiding a major open tracheal resection and reconstruction. This case report is the first to document the use of an ultra-fine Coblation wand in the treatment of congenital tracheal stenosis.Results:The case proceeded well, without any complications. The patient had a fully healed and patent trachea at 12-week post-operative review.Conclusion:Complex cases of congenital stenosis should be managed with a multidisciplinary approach. Different and novel treatment options should be explored to find one that suits the individual patient. Minimally invasive Coblation technology can offer less invasive treatment with quicker recovery and shorter hospitalisation.

Montgomery T-tube for Management of Tracheal Stenosis: A Retrospective Analysis in a Government Hospital of South India

2016 ◽  
Vol 6 (2) ◽  
pp. 73-77
Author(s):  
Myle Mahesh Babu
Keyword(s):  
Retrospective Analysis ◽  
Tracheal Stenosis ◽  
South India ◽  
Good Alternative ◽  
Tracheal Resection ◽  
Laryngotracheal Stenosis ◽  
Government Hospital ◽  
Airway Patency ◽  
T Tube ◽  
Male Preponderance

ABSTRACT This study investigated the outcome of patients who developed tracheal stenosis after tracheostomy or intubation using Montgomery T-tube. We reviewed 21 patients who had experienced tracheal stenosis at a single institution, over 7 years from January 2008 to January 2015. Majority were in the age group of 20 to 30 years and a male preponderance was noted. The duration between extubation and appearance of respiratory symptoms ranged from 32 to 96 days. Location of stenosis was more common in subglottic region (61.9%), followed by tracheal (33.33%) and laryngotracheal stenosis (4.7%). At the end of 6 months, 18 of 21 patients were decannulated successfully and 3 were decannulated at the end of 9 months. Our study showed that use of Montgomery T-tube for laryngotracheal stenosis gave complete improvement in all the patients. Tracheal resection and anastomosis is the definitive surgical treatment of choice in tracheal stenosis but when surgical management is not feasible T-tube is a good alternative and T-tube as front line of management has produced complete improvement in airway patency and restoration of voice in our study. How to cite this article Babu MM, Kumar RA, Thirugnanamani R. Montgomery T-tube for Management of Tracheal Stenosis: A Retrospective Analysis in a Government Hospital of South India. Int J Phonosurg Laryngol 2016;6(2):73-77.

Orally Inhaled Drug Particle Transport in Computerized Models of Laryngotracheal Stenosis

2020 ◽  
pp. 019459982095967
Author(s):  
Dennis Onyeka Frank-Ito ◽  
Seth Morris Cohen
Keyword(s):  
Tracheal Stenosis ◽  
Particle Transport ◽  
Particle Deposition ◽  
Inhaled Corticosteroids ◽  
Academic Medical Center ◽  
Subglottic Stenosis ◽  
Laryngotracheal Stenosis ◽  
Drug Particle ◽  
Computed Tomography Images ◽  
Stenotic Segment

Objective Adjuvant management for laryngotracheal stenosis (LTS) may involve inhaled corticosteroids, but metered dose inhalers are designed for pulmonary drug delivery. Comprehensive analyses of drug particle deposition efficiency for orally inhaled corticosteroids in the stenosis of LTS subjects are lacking. Study Design Descriptive research. Setting Academic medical center. Methods Anatomically realistic 3-dimensional reconstructions of the upper airway were created from computed tomography images of 4 LTS subjects—2 subglottic stenosis and 2 tracheal stenosis subjects. Computational fluid dynamics modeling was used to simulate airflow and drug particle transport in each airway. Three inhalation pressures were simulated, 10 Pa, 25 Pa, and 40 Pa. Drug particle transport was simulated for 100 to 950 nanoparticles and 1 to 50 micron-particles. Particles were released into the airway to mimic varying inhaler conditions with and without a spacer chamber. Results Based on smallest to largest cross-sectional area ratio, the laryngotracheal stenotic segment shrunk by 57% and 47%, respectively, for subglottic stenosis models and by 53% for both tracheal stenosis models. Airflow resistance at the stenotic segment was lower in subglottic stenosis models than in tracheal stenosis models: 0.001 to 0.011 Pa.s/mL vs 0.024 to 0.082 Pa.s/mL. Drug depositions for micron-particles and nanoparticles at stenosis were 0.06% to 2.48% and 0.10% to 2.60% for subglottic stenosis and tracheal stenosis models, respectively. Particle sizes with highest stenotic deposition were 6 to 20 µm for subglottic stenosis models and 1 to 10 µm for tracheal stenosis models. Conclusion This study suggests that at most, 2.60% of inhaled drug particles deposit at the stenosis. Particle size ranges with highest stenotic deposition may not represent typical sizes emitted by inhalers.

scholarly journals Our results in surgical treatment of laryngotracheal stenosis, ten years experience

2006 ◽  
Vol 59 (7-8) ◽  
pp. 309-316 ◽  
Author(s):  
Rajko Jovic ◽  
Borislav Baros ◽  
Dejan Djuric ◽  
Milorad Bjelovic ◽  
Karol Canji ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Tracheal Stenosis ◽  
Costal Cartilage ◽  
Segmental Resection ◽  
Laryngotracheal Stenosis ◽  
Cartilage Graft ◽  
T Tube ◽  
Costal Cartilage Graft ◽  
Anterior Posterior ◽  
Stenotic Segment

Introduction. There are numerous techniques for the treatment of laryngotracheal stenosis. The aim of this paper was to present surgical techniques and results of treatment of laryngeal and laryngotracheal stenosis in a ten-year period by retrospective analysis. Material and methods. Medical records of 34 patients (17 male and 17 female) surgically treated for laryngeal or laryngotracheal stenosis between 1995 and 2004 were analyzed. 19 (55.9%) patients had previous surgical procedures, whereas fifteen patients (44.1 %) were diagnosed and treated for the first time. Results. 5 patients had a glottic-subglottic stenosis, 11 patients had a subglottic stenosis, 16 patients had subglottic-tracheal stenosis and 2 patients had a glottic-subglottic-tracheal stenosis. 21 patients had normal vocal cord motion, 8 patients showed unilateral vocal cord fixation, and 5 had bilateral vocal cord fixation. Laryngotracheoplasty with anterior-posterior costal cartilage graft was performed in 24 patients, while single stage segmental laryngotracheal resection of the stenotic part was performed in 8 patients. One patient was operated in direct laryngomicroscopy and one with dilatation of the stenotic segment with T tube insertion. The most common complication was the development of granulation due to use of the Montgomery T-tube which was removed in direct laryngomicroscopy. Except for one patient, 33(97%) patients were decannulated. There was no perioperative mortality. Conclusion. Although laiyngotracheoplasty with anterior-posterior costal cartilage graft placement cannot be used in all cases of laryngotracheal stenosis, it was the method of choice in previously operated patients with segmental resection of the stenotic segment. This method requires use of Montgomery T-tube or anesthesiological tube, which is very hard to keep clean. Better recovery, short hospitalization and excellent results were obtained with the cricotracheal segmental resection. .

scholarly journals Median Sternotomy for Innominate Artery Compression Syndrome and Distal Tracheal Stenosis

2021 ◽  
pp. 000313482199867
Author(s):  
Sandeep Sainathan ◽  
Mahesh Sharma
Keyword(s):  
Premature Infant ◽  
Tracheal Stenosis ◽  
Median Sternotomy ◽  
Innominate Artery ◽  
Initial Diagnosis ◽  
Tracheal Resection ◽  
Tracheal Cartilage ◽  
Compression Syndrome

We present a case of a premature infant who had an initial diagnosis of an innominate artery compression syndrome. This was approached by a median sternotomy for an aortopexy. However, the patient was found to have a distal tracheal stenosis due to a tracheal cartilage deficiency and was treated by a tracheal resection and primary anastamosis.

scholarly journals Analysis of 40 patients who underwent tracheal resection due to benign complex tracheal stenosis

2021 ◽  
Author(s):  
Mehmet Furkan Sahin ◽  
Muhammet Ali Beyoglu ◽  
Alkin Yazicioglu ◽  
Erdal Yekeler
Keyword(s):  
Tracheal Stenosis ◽  
Tracheal Resection

TRACHEAL STENOSIS CAUSED BY TRACHEOPATHIA OSTEOPLASTICA: TREATMENT BY CERVICAL TRACHEAL RESECTION WITH RECONSTRUCTION

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 37C
Author(s):  
Chakravarthy B. Reddy ◽  
Sidhu Gangadharan ◽  
Gaetane Michaud ◽  
Adnan Majid ◽  
Armin Ernst
Keyword(s):  
Tracheal Stenosis ◽  
Tracheal Resection ◽  
Tracheopathia Osteoplastica

Anaesthetic management of acquired tracheal stenosis for tracheal resection and reconstruction

Airway ◽  
2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Sunil Rajan ◽  
Jacob Mathew ◽  
BeegamShoufi Kunjumon ◽  
Lakshmi Kumar
Keyword(s):  
Tracheal Stenosis ◽  
Anaesthetic Management ◽  
Tracheal Resection

scholarly journals Reinforcement of an end-to-end Tracheal Resection Anastomosis with Fibrin Glue: A Case Report

2001 ◽  
Vol 80 (4) ◽  
pp. 234-238 ◽  
Author(s):  
Ashutosh Kacker ◽  
Jerry Huo
Keyword(s):  
Case Report ◽  
Fibrin Glue ◽  
Tracheal Stenosis ◽  
Fibrin Sealant ◽  
Primary Anastomosis ◽  
Tracheal Resection ◽  
Short Segment ◽  
Prolonged Intubation ◽  
Airtight Seal ◽  
Fatal Complications

Tracheal resection and primary anastomosis is the treatment of choice for a short-segment stenosis. However, the procedure does carry the risk of two potentially fatal complications: anastomosis breakdown and leak. We describe the case of a 67-year-old man who was treated for a 3-cm tracheal stenosis secondary to a prolonged intubation and multiple tracheostomies. The patient underwent a tracheal resection and primary anastomosis. The anastomosis was reinforced with fibrin sealant, which created an airtight seal. The patient was extubated postoperatively, and he healed without complication. Fibrin sealant is a convenient, safe, and effective material for reinforcing anastomotic suture lines.

scholarly journals Treatment of a case of tracheal stenosis in a dog with tracheal resection and anastomosis

2012 ◽  
Vol 48 (No. 11) ◽  
pp. 339-342 ◽  
Author(s):  
Z. Mutlu ◽  
Acar SE ◽  
C. Perk
Keyword(s):  
General Anesthesia ◽  
Clinical Examination ◽  
Tracheal Stenosis ◽  
Postoperative Period ◽  
Tracheal Resection ◽  
Late Period ◽  
Healthy Life ◽  
Breathing Difficulty ◽  
Cervical Portion ◽  
Resection And Anastomosis

A case of tracheal stenosis in the cervical portion of the trachea was encountered in a 5.5-month-old St. Bernard-Ro􀄴weiler cross dog. Breathing difficulty was seen in the clinical examination and presence of an obvious narrowing between the 3rd–5th cervical tracheal rings was determined in the radiological examination. Under general anesthesia the portion with stenosis was resected and the healthy trachea ends were anastomosed using the split cartilage technique. In the postoperative period the breathing difficulty disappeared and there was no development of a new stenosis in the anastomosis region. In the late period check-up the patient was seen to lead a healthy life.

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