In patients who undergo prolonged endotracheal intubation,
tracheostomy is performed to prevent the tracheal and laryngeal
trauma which may be caused by the intubation tube. In this report, a patient
who was intubated after a cerebrovascular embolism and required a
tracheostomy for 6 months due to decannulation problems is presented. The patient
subsequently developed a tracheomalacia. A stent was inserted and seen to
provide functional support. Upon removal of the stent, the tracheomalacia
improved. Although surgical therapy is claimed to provide higher success rate,
stenting may also be a viable option for the management of tracheomalacia and
improve the quality of life in patients with good general condition.
References
[1]
R. E. Whited, “Posterior Commissure Stenosis Post LongTerm Intubation,” Laryngoscope, Vol. 93, No. 10, 1983, pp. 1314-1318.
[2]
R. Cetto, A. Arora, R. Hettige, et al., “Improving Tracheostomy Care: A Prospective Study of the Multidisciplinary Approach,” Clinical Otolaryngology, Vol. 36, No. 5, 2011, pp. 482-488.
doi:10.1111/j.1749-4486.2011.02379.x
[3]
P. Das, H. Zhu, R. K. Shah, et al., “Tracheotomy-Related Catastrophic Events: Results of a National Survey,” Laryngoscope, Vol. 122, No. 1, 2012, pp. 30-37.
doi:10.1002/lary.22453
[4]
R. B. Mitchell, H. M. Hussey, G. Setzen, et al., “Clinical Consensus Statement: Tracheostomy Care,” Otolaryngology—Head & Neck Surgery, Vol. 148, No. 1, 2013, pp. 6-20.
[5]
H. H. O’Connor and A. C. White, “Tracheostomy Decannulation,” Respiratory Care, Vol. 55, No. 8, 2010, pp. 1076-1081.
[6]
K. L. Christopher, “Tracheostomy Decannulation,” Respiratory Care, Vol. 50, No. 4, 2005, pp. 538-541.
[7]
F. Mondrup, K. Skjelsager and K. R. Madsen, “Inadequate Follow-Up after Tracheostomy and Intensive Care,” Danish Medical Journal, Vol. 59, No. 8, 2012, p. A4481.
[8]
H. C. Grillo, “The history of Tracheal Surgery,” Chest Surgery Clinics of North America, Vol. 13, No. 2, 2003, pp. 175-189. doi:10.1016/S1052-3359(03)00002-4
[9]
C. T. Bolliger, T. G. Sutedja, J. Strausz, et al., “Therapeutic Bronchoscopy with Immediate Effect: Laser, Electrocautery, Argon Plasma Coagulation and Stents,” European Respiratory Journal, Vol. 27, No. 6, 2006, pp. 1258-1271. doi:10.1183/09031936.06.00013906
[10]
T. Shiraishi, K. Kawahara, T. Shirakusa, et al., “Stenting for Airway Obstruction in the Carinal Region,” The Annals of Thoracic Surgery, Vol. 66, No. 6, 1998, pp.1925-1929. doi:10.1016/S0003-4975(98)01059-5
[11]
F. Puma, R. Farabi, M. Urbani, et al., “Long Term Safety and Tolerance of Silicone and Self Expandable Airway Stents: An Experimental Study,” The Annals of Thoracic Surgery, Vol. 69, No. 4, 2000, pp.1030-1034.
doi:10.1016/S0003-4975(00)01092-4
[12]
A. Turkyilmaz, Y. Ayd?n, M. Ermancik, et al., “Post-Entubasyon Trakeal Stenozun Cerrahi Tedavisi,” The Eurasian Journal of Medicine, Vol. 39, No. 3, 2007, pp. 189-193.
[13]
S. Y. Lim, H. Kim, K. Jeon, et al., “Prognostic Factors for Endotracheal Silicone Stenting in the Management of Inoperable Post-Intubation Tracheal Stenosis,” Yonsei Medical Journal, Vol. 53, No. 3, 2012, pp. 565-570.
doi:10.3349/ymj.2012.53.3.565
