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Management of Airway in a Patient with Traumatic Sub-glottic Stenosis

Open Journal of Anesthesiology 2013年第3期3卷 199-200页

作者： Zia Arshad Haider Abbas Sulekha Saxena Jaishri Bogra Department of Anaesthesia KG’s MU Lucknow India.

Tracheal stenosis or tracheal injury is a distressing condition. The silicone tracheal T-tube presents a substitute for stent of this complicated disease. We have come across a case of tracheal perforation in which tracheoplasty was planned. After traceoplasty silicone tracheal T-tube was placed as a stent. We were not able to connect silicone tracheal T-tube with Bain circuit with ET TUBE No. 8.5, 8, 7.5, 7 connector and it was difficult to ventilate the patient now. We have tried other ET TUBE connector and finally we succeeded to connect ET TUBE No. 5.5 connector with Bain circuit and we were able to ventilate the patient.

关键词： Traceoplasty Tracheal T-Tube subglottic Stenosis

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Factors Influencing Prognosis in the Endoscopic Extraction of Foreign Bodies in Kashmiri Population

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第1期8卷 32-48页

作者： M. S. Sheikh S. Gul Afshan Meelad Mohammad Sheikh S. Bunafsha Government Medical Collage R/o Gulshan Nagar Sector-C Srinagar India Women’s Medical Collage Hospital Dhaka Bangladesh Government Dhaka Medical College Dhaka Bangladesh Department of ENT Head and Neck Surgery Government Medical College Srinagar India

An updated approach in the management of 50 patients with foreign body inhalation is presented. Certain risk factors that lead to complications and mortality due to endoscopic extraction of foreign bodies and thus determine prognosis were identified. Remedial measures to reduce morbidity and mortality due to bronchoscopic removal of foreign bodies are suggested. Fifty patients of suspected foreign body inhalation presented to a Unit of the Department of ENT, Head and Neck Surgery of Government Medical College associated SMHS Hospital Srinagar, Kashmir from March 2007 to June 2017. Of these, 49 patients were subjected to rigid tube bronchoscopy for removal of the aspirated foreign bodies and one coughed out the foreign body spontaneously during admission for bronchoscopy. History of foreign body inhalation was positive in 90% of patients and remaining was mostly referred from Paediatric Units with un-resolving collapse-consolidation of the lung. Whereas plain radiography of the chest and the soft tissues of neck were the primary imaging modality used in this study to detect the inhaled foreign bodies or their effects there are reports of virtual bronchoscopy being done with a multidetector computed tomography scanner in 3D image generation from axial cuts of the internal walls of the tracheobronchial tree in the management of patients suspected with foreign body aspiration. Bronchoscopy is a difficult and potentially hazardous procedure in the infant and young child. Telescopes and telescopic forceps were used during bronchoscopy to facilitate extraction of a foreign body inhaled. The type of a foreign body, site of its enlodgement and the complications encountered during its extraction were noted. During bronchoscopy the patients were connected to an ECG monitor and a pulse oximeter. 80% of the patients with foreign body inhalation were children in the age group of 0 - 5 years. There was a definite history of choking over the foreign body in 88% of the patients lead

关键词： Inhaled Foreign Bodies Collapse-Consolidation Obstructive Emphysema Virtual Bronchoscopy Rigid Tube Bronchoscopy Hypoxic Bradycardia Bronchospasm subglottic Oedema Pneumothorax Tracheostomy Prognosis

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Laryngotracheal stenosis in burn patients requiring mechanical ventilation

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2018年第2期4卷 117-121页

作者： Yekaterina A. Koshkareva William B. Hughes Ahmed M.S. Soliman Department of Otolaryngology — Head & Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia PA USA Temple Burn Center Lewis Katz School of Medicine at Temple University Philadelphia PA USA

Objective: To identify the incidence of laryngotracheal stenosis (LTS) in burn pa-tients requiring mechanical ventilation at a regional academic burn center. Methods: A retrospective review of all burn patients requiring endotracheal intubation or tra-cheostomy for airway management between 2003 and 2009 was performed. A group of trauma patients requiring similar airway instrumentation during the same period of time was used as a control. Results: None of the trauma patients and 2 of the burn patients developed LTS. Both presented with stridor and were diagnosed within 2—5 weeks after extubation. One patient underwent successful carbon dioxide laser radial incision and dilation and continues to do well. The other patient failed endoscopic treatment and required T-tube placement. The incidence of LTS in burn patients requiring mechanical ventilation was 2.98％ overall and 4.76％ among those with inhalational injury. Conclusions: Patients become symptomatic within weeks of the initial injury. Treatment is challenging and multiple surgical procedures are often required. A larger study is necessary to determine if the incidence is higher among burn patients.

关键词： Laryngeal stenosis Tracheal stenosis subglottic stenosis Adult Burn Inhalation

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