Subglottic stenosis after thoracotomy--a case report.
Traumatic intubation, reintubation, intubation with endotracheal tube of inappropriate size, and failure to firmly secure the tube may contribute to the development of subglottic stenosis. Systemic factors such as sepsis, hypotension, autoimmune and granulomatous disorders have all been implicated as contributing causes. In addition, a risky circumstance that might be considered important in the development of airway damage is the occurrence of gastreoesophageal reflux (GER), particularly in thoracotomy operations, where the patients are placed in the lateral position. The purpose of this report is to describe a patient who developed subglottic stenosis following a thoracotomy. The possible causes are macrotrauma due to multiple intubations and microtrauma due to inappropriate tube size in the course of anesthesia. Furthermore, GER may worsen mucosal injuries, which may be precipitated by the lateral position.
Lin
Bo-Feng
BF
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Lee
Shih-Chun
SC
Kao
Chuan-Hsiang
CH
Tsung
Yu-Chi
YC
Kuo
Chang-Po
CP
Wong
Chih-Shung
CS
Wu
Ching-Tang
CT
D000368:Aged; D005260:Female; D005931:Glottis; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007829:Laryngostenosis / Q000209:etiology*; D011187:Posture; D013908:Thoracotomy / Q000009:adverse effects*