BRONCHOSCOPIC BALLOON DILATATION COMBINED WITH ELECTRIC CAUTERIZATION OF TRACHEAL STENOSIS UNDER CONSCIOUS SEDATION: A CASE REPORT

2021 ◽  
pp. 10-11
Author(s):  
Geeta Choudhary ◽  
Prashant Prashant ◽  
Bharti Verma
Keyword(s):  
Tracheal Stenosis ◽  
Conscious Sedation ◽  
Past History ◽  
Balloon Dilation ◽  
Upper Airway ◽  
Spontaneous Ventilation ◽  
Treatment Modalities ◽  
Tracheal Resection ◽  
Safe Procedure ◽  
Endoscopic Procedures

Post intubation tracheal stenosis remains the most common indication of tracheal resection and reconstruction. It can cause respiratory symptoms that can often be misdiagnosed as obstructive lung disease. Various treatment modalities are available. As ofce-based procedures have been common, awake or mildly sedated endoscopic procedures with spontaneous ventilation are now being performed by exible bronchoscopy. We report a case involving a 45-year-old male who presented with dyspnea and stridor from 15 days. Patient had past history of intubation and icu stay one month back. After proper topicalization of upper airway of the patient, electric cauterization and balloon dilation was performed by exible bronchoscope under conscious sedation and spontaneous ventilation. Conscious sedation was achieved by graded doses of propofol and fentanyl. Post-operative period was uneventful, and patient didn’t describe any discomfort. Improvement in symptoms were reported. Endoscopic procedures for tracheal pathology under conscious sedation seems to be feasible and safe procedure.

scholarly journals CPAP after endoscopic procedures as add-on therapy for the treatment of tracheal stenosis: a case series

2019 ◽  
Vol 89 (3) ◽  
Author(s):  
Adriano Gesuele ◽  
Simone Gambazza ◽  
Marta Lazzeri ◽  
Serena Conforti
Keyword(s):  
Tracheal Stenosis ◽  
Positive Airway Pressure ◽  
Positive Impact ◽  
Case Series ◽  
Long Term Results ◽  
Tracheal Resection ◽  
Endoscopic Procedures ◽  
Frequent Relapses

Tracheal stenosis represents a possible complication in intubated or tracheotomised patients. Tracheal resection is currently the gold standard for the treatment of complex stenosis while granulomas and simple stenosis (e.g., web-like) are often treated by endoscopic procedures, which do not consistently give satisfactory long-term results, due to frequent relapses. Administering continuous positive airway pressure (CPAP) after endoscopic procedures might represent a new add-on option for the treatment of this complication. In this case series are presented two patients with tracheal stenosis showed after the removal of tracheostomy tube, both treated with CPAP. The results were straightforward: CPAP treatment helped to keep stable the tracheal lumen, without adverse effects. No further endoscopic dilations were necessary thereafter, with a likely positive impact on patients’ quality of life and on health expenditure.

Upper Airway Injury in Dogs Secondary to Trauma: 10 Dogs (2000–2011)

2016 ◽  
Vol 52 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Eleni Basdani ◽  
Lysimachos G. Papazoglou ◽  
Michail N. Patsikas ◽  
Georgios M. Kazakos ◽  
Katerina K. Adamama-Moraitou ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Aspiration Pneumonia ◽  
Tracheal Stenosis ◽  
Subcutaneous Emphysema ◽  
Upper Airway ◽  
Tracheal Resection ◽  
Air Leakage ◽  
Tracheal Rupture ◽  
Airway Injury ◽  
End To End

ABSTRACT Ten dogs that presented with trauma-induced upper airway rupture or stenosis were reviewed. Tracheal rupture was seen in seven dogs, tracheal stenosis in one dog, and laryngeal rupture in two dogs. Clinical abnormalities included respiratory distress in five dogs, subcutaneous emphysema in eight, air leakage through the cervical wound in seven, stridor in three dogs, pneumomediastinum in four and pneumothorax in one dog. Reconstruction with simple interrupted sutures was performed in four dogs, tracheal resection and end-to-end anastomosis in five dogs, and one dog was euthanized intraoperatively. Complications were seen in three dogs including aspiration pneumonia in one and vocalization alterations in two dogs.

scholarly journals Reconstructive surgeries on the larynx and cervical trachea in children

2021 ◽  
Vol 24 (6) ◽  
pp. 383-387
Author(s):  
A. Yu. Razumovsky ◽  
D. N. Strizhova
Keyword(s):  
Respiratory Tract ◽  
Reconstructive Surgery ◽  
Balloon Dilation ◽  
Surgical Techniques ◽  
Upper Airway ◽  
Tracheal Resection ◽  
Upper Respiratory Tract ◽  
Endoluminal Surgery ◽  
Airway Narrowing ◽  
Upper Respiratory

Introduction. One of the urgent problems in pediatric surgery and otorhinolaryngology is stenosis of the upper respiratory tract in children. Among many causes leading to airway narrowing , basic ones are: cicatricial stenosis, bilateral vocal cord paralysis and volumetric formations.Diagnostics. Currently, fibroscopy of the upper respiratory tract is a gold standard of this pathology examination.Methods. There are many surgical techniques to treat upper airway stenosis, but currently there is no any unified approach to the choice of surgical tactics. The given article presents an overview on modern techniques of reconstructive surgery which have demonstrated good and excellent results and a high percentage of decannulation. Among them, there are two basic ones - endoluminal surgery and open surgery. Recently, reports on the effectiveness of microsurgical interventions have been published , namely, reinnervation of the larynx to restore vocal cords. The most effective endoscopic surgeries in pediatrics are balloon dilation, bougienage and CO2- laser treatment. Patients with stenosis of stages III-IV, with extended stenosis, marked laryngomalacia, larynx and trachea deformity because of unsuccessful previous surgeries are recommended to have open reconstructive surgery. Laryngoplasty, laryngoplasty with T-tube and crico-tracheal resection are regarded as a choice option in case of ineffective previous surgeries.Conclusion. Thus, type of surgical intervention, indications and patient’s age for surgery are chosen individually for each patient with upper respiratory tract stenosis.

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 Upper Airway Nerve Block for Rigid Bronchoscopy in the Patients with Tracheal Stenosis: A Case Serie

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Parviz Amri ◽  
Novin Nikbakhsh ◽  
Seyed Reza Modaress ◽  
Ramin Nosrati
Keyword(s):  
Respiratory Distress ◽  
Nerve Block ◽  
Tracheal Stenosis ◽  
Superior Laryngeal Nerve ◽  
Upper Airway ◽  
Rigid Bronchoscopy ◽  
Laryngeal Nerve ◽  
Intravenous Sedation ◽  
Nerve Blocks

Background: Rigid bronchoscopy is often used to diagnose and treat the location of resection of the tracheal stenosis. It is a selective procedure for the dilatation of tracheal stenosis, especially when accompanied by respiratory distress. Objectives: We introduced patients who were diagnosed with tracheal stenosis and candidate for rigid bronchoscopy dilatation by the upper airway nerve blocks. Methods: This prospective observational study was conducted on 17 patients who underwent dilatation with rigid bronchoscopy in tracheal stenosis at Hospitals affiliated with Babol University of Medical Sciences from 2002 to 2017. The patients were given three nerve blocks, 6 bilateral superior laryngeal nerve block, bilateral glossopharyngeal nerve block, and recurrent laryngeal nerve block (transtracheal) before awake rigid bronchoscopy using 2% lidocaine. We evaluated the demographic data, the cause of tracheal stenosis, the quality of the airway nerve block (Intubation score), patients’ satisfaction from bronchoscopy and thoracic surgeons’ satisfaction. Complications of nerve blocks were recorded. Results: From 2002 to 2017, 17 patients (14 were male and 3 were) female with tracheal stenosis who were candidates for dilatation with bronchoscopy and accepted the upper nerve block were included. The quality of the block was acceptable in 16 (94%) patients. 15 patients received fentanyl, and only two patients did not need to intravenous sedation. The mean age of patients was 29.59 ± 11.59. The average satisfaction of the surgeon was 8.82 ± 1.13 and the satisfaction of patients with anesthesia was 8.89 ± 1.16. There was one serious complication (laryngospasm) in one patient. Conclusions: The upper airway nerve block method is a suitable anesthesia technique for patients with tracheal stenosis who are candidates for the tracheal dilatation with rigid bronoscopy, especially when the patient has respiratory distress and has not been evaluated before surgery.

scholarly journals Flexible Nasal Endoscopic Procedures in Family Medicine: Indications and Effectiveness

2021 ◽  
Vol 53 (10) ◽  
pp. 886-889
Author(s):  
John Malaty ◽  
Dongyuan Wu ◽  
Susmita Datta
Keyword(s):  
Family Medicine ◽  
Laryngopharyngeal Reflux ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
True Vocal Cord ◽  
Endoscopic Procedures ◽  
Specialist Referral ◽  
Postnasal Drip ◽  
The University

Background and Objectives: Most literature about flexible nasolaryngoscopy comes from specialty clinics, making it unclear if these indications can be effectively managed without referral. This study evaluated effectiveness of diagnosis and management of upper airway complaints, utilizing flexible nasal endoscopic procedures, in a family medicine center. Methods: We performed retrospective chart review for all patients who had nasal endoscopy, nasopharyngoscopy, and nasolaryngoscopy performed at the University of Florida Family Medicine Center over 3 years (n=89) with 5 additional years of follow up. We used descriptive statistics to evaluate indications, diagnoses, effectiveness of management by family medicine, and referral rate. Results: The most common primary indications were hoarseness (n=33, 37%), chronic cough (n=20, 22%), nasal obstruction (n=9, 10%), and unilateral ear dysfunction (n=6, 7%). The most common primary diagnoses found were allergic rhinitis/postnasal drip (n=41, 46%), laryngopharyngeal reflux (LPR)/gastroesophageal reflux disease (GERD; n=24, 27%), masses concerning for malignancy (n=4, 4.5%), true vocal cord (TVC) polyp (n=3, 3%), TVC nodules (n=3, 3%), and epistaxis (n=3, 3%). Of the four concerning masses, two were confirmed cancers (2%). In addition, there was one case (1%) of erythroleukoplakia with dysplasia of the TVC. Most patients had documented improvement with family medicine management (n=57, 64%) and another six (7%) had follow up without documentation of status and no need for referral. Thus, a total of 71% (n=64) did not require referral and 20% (n=18) needed specialist referral. Conclusions: Flexible nasal endoscopic procedures are effective in the care of patients in a family medicine residency center and can be safely performed and taught to residents.

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