An unusual aspect of tracheal stenosis. Case report.
lnjury of the tracheal mucosa at the decubitus site of the endotracheal tube cuff during prolonged endotracheal intubation and resulting fibrin deposits may predispose for the development of tracheal stenosis. Frequent endoscopic control examinations, following the increased use of dilation tracheostomy techniques, have revealed a considerable number of these once misrecognized complications in laryngeal and tracheal structures alike. The case reported here appears to confirm this sequence of events. Timely operative endoscopy using a pair of pincers mounted on a rigid endoscope permitted the removal of the fibrin membrane causing the tracheal lumen stenosis and allowed us to achieve complete and definitive recalibration of the trachea, with restoration of spontaneous breathing. Cortisone therapy prolonged for 5 days probably prevented recurrence of the stenosis. Follow-up was carried out in 3 phases. The 1(st) phase included early control using tracheal endoscopy; 2(nd) comprised neck CT scan to examine the tracheal lumen 15 days after endoscopic control, and the 3rd phase involved medical examination after about 3 months and neck radiography in 2 projections.
Lesmo
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Anesthesia and Resuscitation Unit, S. Carlo Borromeo Hospital, Milan, Italy.
Ripamonti
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D
D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology*