Postintubation tracheal stenosis.
Postintubation tracheal stenosis is caused by either cuff-induced ischemic damage to the trachea, stomal injury from a tracheostomy, or a combination of the two. Patients who present with stridor or unexplained dyspnea after a period of mechanical ventilation should be investigated for postintubation tracheal stenosis. Most patients with such an injury are candidates for tracheal resection and reconstruction. The length of the anticipated resection is the most important determinant of resectability. Tracheal resection is now a standardized operation with predictable, reliable, good results. The principles of operative repair include precise bronchoscopic assessment, complete tracheal mobilization, dissection close to the trachea to avoid recurrent nerve injury, and precise anastomotic technique.
Wain
John C
JC
Thoracic Surgical Unit, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. jwain@partners.org
D001999:Bronchoscopy / Q000009:adverse effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D012121:Respiration, Artificial / Q000009:adverse effects; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*