A rare case of tracheoesophageal puncture with party wall necrosis

Abstract Acquired benign tracheoesophageal fistula (TOF) is a rare medical condition that usually results from trauma, foreign bodies or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who has had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which has led to the formation of a TOF. Due to the patient’s obsessive habit, we could not manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar aetiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

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Use of Ultrasound for Sizing Tracheoesophageal Puncture Prostheses

Otolaryngology ◽

10.1177/0194599817722947 ◽

2017 ◽

Vol 157 (6) ◽

pp. 1075-1078

Author(s):

Aaron Smith ◽

Vikrum Thimmappa ◽

Julia Jones ◽

Courtney Shires ◽

Merry Sebelik

Keyword(s):

Wall Thickness ◽

Gold Standard ◽

Total Laryngectomy ◽

Primary Closure ◽

Ultrasound Measurement ◽

Voice Rehabilitation ◽

Flap Reconstruction ◽

Tracheoesophageal Puncture ◽

Party Wall ◽

Posterior Tracheal Wall

Tracheoesophageal puncture (TEP) with voice prosthesis placement is the gold standard voice rehabilitation following total laryngectomy. Ultrasound may be useful to determine tracheoesophageal wall thickness, guiding prosthesis choice. Therefore, 14 patients undergoing total laryngectomy and TEP or prosthesis change with 16-mHz ultrasound measurement of the posterior tracheal wall were included. Seven patients underwent secondary TEP, 3 primary TEP, and 4 TEP changes. Six patients underwent flap reconstruction, while 8 patients were closed primarily. Average party wall thickness was 9.6 ± 1.7 mm, without a difference ( P = .08) between primary closure (10.3 ± 1.7 mm) and flap reconstruction (8.6 ± 1.4 mm). Change from the hypothesized sizing was noted in 11 patients (79%). Prosthesis size did not correlate with age (–0.19, P = .51), height (–0.12, P = .69), weight (0.26, P = .38), body mass index (0.22, P = .46), or flap status (–0.48, P = .079). These data suggest that ultrasound is beneficial in patients with distorted or less predictable anatomy (eg, flap reconstruction) but also important for those patients undergoing primary closure.

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Identification of Pulmonary Deposits from a Sandpaper Worker: A Study by Electron Microscopy and X-Ray Microanalysis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100053061 ◽

1982 ◽

Vol 40 ◽

pp. 52-53

Author(s):

S. K. Peng ◽

M.A. Egy ◽

J. K. Singh ◽

M.B. Bishop

Keyword(s):

Electron Microscopy ◽

Environmental Pollution ◽

Rare Case ◽

Interstitial Fibrosis ◽

X Ray ◽

Documented Case ◽

Etiologic Agents ◽

Pulmonary Interstitial Fibrosis ◽

Gold Miners ◽

Pulmonary Changes

Electron microscopy and energy dispersive x-ray microanalysis (EDXA) are found to be very useful tools for identification of etiologic agents in pneumoconiosis or interstitial pulmonary disorders. Pulmonary interstitial fibrosis and granulomatosis are frequently associated with occupational and environmental pollution. Numerous reports of pneumoconiosis in various occupations such as coal and gold miners are presented in the literature. However, there is no known documented case of pulmonary changes in workers in the sandpaper industry. This study reports a rare case of pulmonary granulomatosis containing deposits from abrasives of sandpaper diagnosed by using EDXA.

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