Use of a silicone T-tube for management of a tracheal injury in a patient with cervical blunt trauma.
A 71-year-old woman fell forward hitting the anterior part of her neck against a table. Bronchoscopy revealed deformation of the cartilage crescent in the cervical trachea (suggestive of cartilage contusion) and a longitudinal tear in the membranous region. Because subcutaneous emphysema and dyspnea developed and progressed, we made a tracheostomy and inserted a silicone T-tube through the stoma to relieve intraluminal pressure. This then served as a stent for the airway after the patient had progressed through the acute stage. The subcutaneous emphysema and pneumomediastinum abated gradually during the 7 days after insertion of the T-tube, which remained in the cervical trachea as a tracheal stent for 2 months thereafter. The T-tube is easy to manage and can be inserted through the stoma without major surgery. As an alternative to tracheotomy, the T-tube is nonirritating, allows speech, aspiration of sputum, and respiration through the nasopharynx, and in general requires little if any special maintenance or cleaning. Furthermore, a relatively long T-tube can be used, and so the stent can occupy a longer section of the trachea than can a tracheostomy tube. We recommend the placement of a T-tube to provide a useful stent for cervical tracheal injury.
Shimizu
Junzo
J
Department of Surgery, Saiseikai Kanazawa Hospital, Kanazawa, Ishikawa, Japan.
Hirano
Yasumitsu
Y
Ishida
Yoshinori
Y
Kinoshita
Takahiro
T
Tatsuzawa
Yasuhiko
Y
Kawaura
Yukimitsu
Y
D000368:Aged; D005260:Female; D006801:Humans; D019838:Neck Injuries / Q000150:complications* / Q000628:therapy; D015607:Stents; D013352:Subcutaneous Emphysema / Q000209:etiology; D014132:Trachea / Q000293:injuries*; D014139:Tracheostomy; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000628:therapy