Mediastinal obstruction of the trachea.
Acute tracheal obstruction by a mediastinal mass is uncommon in otolaryngologic practice. Choosing techniques for securing the airway, induction of anaesthesia, and the surgical approach require careful deliberation. We report our experience in a patient with acute respiratory distress due to external compression of the trachea in the mediastinum by metastatic carcinoma. We used a fibre-optic bronchoscope ensheathed by an endotracheal tube to secure the airway. Standard tracheotomy tubes were too short to splint open the obstruction in the distal trachea, whereas the long Montgomery T-tube was effective.
Hosal
S A
SA
Department of Otolaryngology, University of Toronto, Faculty of Medicine, Mount Sinai Hospital, Ontario.
Fisher
J A
JA
Freeman
J L
JL
D000208:Acute Disease; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology*; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000556:secondary / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery; D014140:Tracheotomy