Tracheotomy-coblation for acquired subglottic tracheal stenosis: a case report
- PDF / 6,692,675 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 32 Downloads / 159 Views
(2019) 14:128
CASE REPORT
Open Access
Tracheotomy-coblation for acquired subglottic tracheal stenosis: a case report Jingtao Huang*, Zhongwei Zhang and Tao Zhang
Abstract Background: Tracheal stenosis caused by tracheotomy and intubation is considered intractable. Although the segmental tracheal resection and endoscopic intervention are available, they usually result in great operation injury or are difficult to perform. Case presentation: A patient with acquired tracheal stenosis was treated with tracheotomy-coblation. The patient was followed up by bronchoscopy every 2 months. After 6-month follow-up, the symptoms of dyspnea and hoarseness disappeared and no tracheal stenosis was observed. Conclusions: The present technique, tracheotomy-coblation, is advantageous with less injury and easy to perform. Keywords: Acquired subglottic tracheal stenosis, Tracheotomy-coblation, Tracheal stenosis
Introduction Acquired tracheal stenosis is considered as challenging due to difficult field visualization and instrument limitation. Coablation has advantages including rapid and precise ablation, little thermal damage, et al. However, more data is still needed to demonstrate the potential of coblation in managing airway stenosis [1]. Here, we report a novel technique using tracheotomy-coblation for treating subglottic tracheal stenosis that was resulted from post-intubation. Case presentation This study was approved by the ethic committee of Tianjin Nankai Hospital. In February 2016, a patient (male, 26 years old) who fell from a great height and suffered from multiple fractures in the pelvic and legs underwent tracheal intubation and tracheotomy. Two months after, the tracheotomy catheter was removed and dyspnea occurred. Laryngoscopy showed granuloma hyperplasia combined with tracheal stenosis, and endotracheal intubation was performed by means of tracheostomy. Afterwards, the patient received several orthopedic surgeries, but the tracheal stenosis was left untreated. Five months prior to admission to our hospital, the patient was diagnosed as acquired tracheal * Correspondence: [email protected] Department of Thoracic Surgery, Tianjin Nankai Hospital, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China
stenosis and he refused multi-cryoablation therapy. According to computed tomography (CT) examination and bronchoscopy, it’s a 2 cm stenosis located at 2.5 cm below the glottis and the inner surface of the stenosis was smooth and completely epithelialized (Fig. 1). The mobility and appearance of the vocal cords were normal without obvious inflammation. The patient was treated with tracheotomy-coblation; in trendelenburg’s position, the tracheal catheter was simply substituted by tracheal intubation under general anesthesia. The trachea was cut open to disassociate the anterior tracheal wall (2.5 cm-length). A syringe was used to puncture upward the anterior tracheal wall to determine the range of the stenosis. The coablation was performed with the tracheal cartilage as the anatomical landmark. After the tra
Data Loading...
