title: Tracheo-innominate artery fistula: a rare complication in a laryngectomized patient.
abstract: A tracheo-innominate artery fistula is an uncommon but frequently fatal complication of tracheostomy. Rarely, it can also occur in laryngectomized patients. We report a post-laryngectomy, post-radiotherapy patient using a metal tracheostomy tube, who developed a tracheo-innominate artery fistula about two months after radiotherapy. To our knowledge this is only the second reported case in a laryngectomized patient. The computed tomography (CT) angiography findings helped confirm the diagnosis and the patient was successfully managed by surgical exploration and ligation of the innominate artery. Coagulase negative Staphylococcus aureus was cultured from a tracheal swab. The clinical features, CT angiography findings, management protocols and possible aetiological factors are discussed.
authors.affiliation: Department of ENT and Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka State, India. lib.kmc@manipal.edu
authors.forename: Produl
authors.initials: P
authors.lastname: Hazarika
authors.forename: S Ganesh
authors.initials: SG
authors.lastname: Kamath
authors.forename: R
authors.initials: R
authors.lastname: Balakrishnan
authors.forename: Raj
authors.initials: R
authors.lastname: Girish
authors.forename: Kundaje
authors.initials: K
authors.lastname: Harish
mesh_terms: D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014133:Tracheal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology*