RESUMO
BACKGROUND: Tracheomalacia (TM), caused by anterior mediastinal tumorectomy, most likely to deteriorate condition of patient life. CASE PRESENTATION: A 63-year-old patient felt serious dyspnea diagnosis as TM caused by the recurrent cervical schwannoma. The narrowest diameter of the TM was only 0.446 cm and the length of malacic segment was 7.47 cm. Here we designed a novel tracheal suspension technique by using autogenous rib cartilage graft to treat severe TM. The obvious effect was observed that the inner diameter increased from 0.446 cm to 1.390 cm,and the airway symptom was alleviated. CONCLUSION: The autogenous rib cartilage graft used for suspending the malacic trachea was safe and effective.
Assuntos
Cartilagem Costal/transplante , Procedimentos de Cirurgia Plástica/métodos , Costelas/transplante , Traqueia/cirurgia , Traqueomalácia/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Traqueomalácia/diagnósticoRESUMO
This case shows the importance of the early diagnosis of the tracheomalacia and the treatment of asphyxia in thyroid huge mass.
RESUMO
Tracheobronchomalacia (TBM) is frequently present in infants and children with congenital heart disease (CHD). Infants with CHD and TBM appear to do worse than those without TBM. The principle of operative intervention for TBM is to improve function of the airway and clinical status. When indicated, conventional surgical options include tracheostomy, aortopexy, tracheoplasty, and anterior tracheal suspension. There is no consensus on the optimal treatment of severe tracheobonchomalacia, which can be associated with a mortality rate as high as 80%. Congenital tracheal stenosis is also frequently associated with CHD (vascular rings, atrioventricular canal defects, and septal defects) and may require concomitant repair. Repair of tracheal stenosis is often associated with distal TBM. This article addresses new techniques that can be performed in corrective surgery for both TBM and congenital tracheal stenosis.
Assuntos
Brônquios/cirurgia , Constrição Patológica/cirurgia , Procedimentos Cirúrgicos Torácicos , Traqueia/anormalidades , Traqueia/cirurgia , Traqueobroncomalácia/cirurgia , Brônquios/anormalidades , Brônquios/fisiopatologia , Constrição Patológica/diagnóstico , Constrição Patológica/mortalidade , Constrição Patológica/fisiopatologia , Difusão de Inovações , História do Século XX , História do Século XXI , Humanos , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Procedimentos Cirúrgicos Torácicos/história , Procedimentos Cirúrgicos Torácicos/tendências , Traqueia/fisiopatologia , Traqueobroncomalácia/diagnóstico , Traqueobroncomalácia/mortalidade , Traqueobroncomalácia/fisiopatologia , Resultado do TratamentoRESUMO
Objective To discuss the diagnosis and management of tracheomalacia complicating large goiter. Methods Clinical data of 36 patients with large goiter complicated by tracheomalacia at Xijing Hospital between 1992 and 2004 were retrospectively reviewed. Preoperative Valsalva-Mueller test were performed in all patients before undergoing subtotal thyroidectomy with tracheal suspension, and two patients were treated by subtotal thyroidectomy with tracheal suspension and tracheostomy. Results Valsalva-Mueller test was positive in all patients. The compressed tracheal cartilage disappeared in 2 cases, became thin and soft in other 34 cases. Thirty-four patients who underwent subtotal thyroidectomy with tracheal suspension recovered and 2 patients were resued by tracheal suspension with tracheostomy. There was no mortality. Postoperative 34 cases were followed-up from 6 months to 13 years. Thirty-two cases had no postoperative respiratory obstruction, 2 patients died of unrelated diseases. Conclusions The diagnosis of tracheomalacia from large goiter is based on Valsalva-Mueller test and operative detection. Subtotal thyroidectomy with tracheal suspension is the treatment of choice for tracheomalacia complicating large goiter.
