ABSTRACT
Tracheal stenosis is well known complication of endotracheal intubation. However, severe post intubation tracheal stenosis that requires interventional bronchoscopy or tracheal surgery is un-common. Necrosis induced by cuff pressure-related loss of regional blood flow is the central injury leading to postinubation tracheal stenosis. The large volume, low pressure cuff of endo-tracheal tubes have markedly reduced the occurrence cuff-induced injury. However, in any patient who develops symptoms of airway obstruction, who has been intubated and ventilated in the recent past, possibility of tracheal stenosis should be considered. We report a case of severe tracheal stenosis by tracheal web formation a 52-year-old following ventilator therapy for ARDS.
Subject(s)
Humans , Middle Aged , Airway Obstruction , Bronchoscopy , Intubation , Intubation, Intratracheal , Necrosis , Regional Blood Flow , Tracheal Stenosis , Ventilators, MechanicalABSTRACT
The complications of endotracheal intubation are inevitable, of which postintubation tracheal stenosis may be required for surgical resection with primary reconstruction. Before surgery, several less invasive therapeutic modalites including bougie dilatation, stenting, and Nd-YAG laser incision are still available in use. Especially, good results were noted in selected patients with lengthy scars of less than 1cm and without tracheomalacia using endoscopic laser incision and dilatation. We report a case of a 54 yr-old woman with postintubation tracheal stenosis who was successfully treated by endoscopic Nd-YAG laser incision and esophageal balloon catheter.