• 제목/요약/키워드: Tracheal stenosis

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혈관화된 쇄골을 이용한 기관재건술 (Laryngotracheal Reconstruction Using The Vascularized Clavicle)

  • 정동학;송승용;윤정선;정영석
    • 대한기관식도과학회지
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    • 제3권2호
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    • pp.327-331
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    • 1997
  • One of the most difficult airway problems is a subglottic stenosis combined with a tracheal stenosis. Laryngotracheal stenosis has not been completely solved with classic methods like cricotracheal split with autogenous cartilage graft, thyrotracheal anastomosis, and free hyoid or hyoid-sternohyoid myo-osseous flap reconstruction. A 28-near-old male patient who had had laryngotracheal stenosis was successfully treated by laryngotracheal reconstruction using vascularized clavicle. This method has a several advantages: the vascularized clavicle harvesting in the same operative fields, one stage operation, less restenosis due to plentyful blood supply, md prevention of airway collapse due to a clavicle provided framework. It is too early to make a definite conclusion, but the authors suggested that this method could become one of the most effective methods of laryngotracheal stenosis.

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기관 재건술 후 발생한 기관 무명동맥루 (Tracheoinnominate Artery Fistula after Tracheal Reconstruction)

  • 곽영태;신원선;맹대현;이신영;김수철;박주철;김동원
    • Journal of Chest Surgery
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    • 제29권11호
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    • pp.1288-1291
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    • 1996
  • 기관 무명동맥루는 매우 드문 질환이지만 일단 발생하면 예후가 아주 불량하며 치명적일 수 있다. 본 인제대학교 상계백병원 흉부외과학 교실에서는 한 명의 환자에서 기관 절개술 후 합병된 기관 협착증에 대한 기관 재건술 후 기관 무명동맥루가 발생하였다. 본 례는 11세의 소녀로 뇌동정맥 기형으로 뇌실외 유출로 조성술 및 4회에 걸친 신경외과적 수술을 받은 환자로서 6개월 전에 기관 절개술을 받았다. 이기관 절개술 후 5개월 후부터 호홉 곤란과 발작성 기침을 호소하여 기관 협착증으로 진단받고 본과로 전과되어 기관 협착 부위의 절제 및 단단 문합으로 기관 재건술을 시행하였다. 기관 재건술 후 3일째 다량의 출혈이 발생하여 기관 무명동맥루로 진단하였고 무명 동맥의 파열 부위의 봉합 및 기관의 재 재건술로 응급수술을 시행하였으나 재 수술후 3일째 재 출혈로 사망하였다.

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기관삽관에 후발한 기관협착증의 외과적 치료 (The Surgical Treatment of the Tracheal Stenosis Following Tracheostomy and Intubation)

  • 이상호;노준량
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.339-344
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    • 1981
  • Eight patients underwent tracheal resection and reconstruction for tracheostomy and postintubation injuries from 1971 to early 1981. The ages ranged from 12 years to 59 years. The patients had 7-cuff stenosis and one stomal lesion in whom intubated long. Four male and four female patients were treated. Cervical approach was used in one, cervicomediastinal in 3 and transthoracic in four. The longest length of resection extended to 4 cm in whom cervico-upper half mediastinal incision and neck flexion were applied. Techniques for obtaining tension-free anastomosis included cervical flexion or division of the inferior pulmonary ligament and mobilization of the right hilum. Concurrent tracheostomy was not needed in all. There was one death at the end of emergency operation from anesthetic accident. Granulations at the anastomosis line, necessitating bronchoscopy, were noted in two and the lesion did not recurred after removal. No restenosis or other complications occurred during long follow-up.

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Superiorly based flap을 이용한 기관절개술 (Superiorly Based Flap Tracheostomy)

  • 정필상;이정구;정필섭;김영훈
    • 대한기관식도과학회지
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    • 제1권1호
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    • pp.129-135
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    • 1995
  • The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.

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Clinical evaluation of Tracheal stenosis

  • 박영학;최지영;진선영;조정해;조승호
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 2010년도 제53차 학술대회 초록집
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    • pp.36-36
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    • 2010
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기관 캐뉼 발거 곤란증 (Decannulation Difficult)

  • 봉정표;임구일;유기원;이준규;박성원;홍기수
    • 대한기관식도과학회지
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    • 제4권2호
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    • pp.165-170
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    • 1998
  • Background and Objectives : Decannulation failure may result from factors such as inadequate ability 0 clear secretion, mucosal induration, granulation tissue, restenosis, tracheal wall depression and vocal cord palsy. We were to evaluate the effectiveness of surgical treatment on the basis of site and type of stenosis. Materials and Method : A series of 44 cases of decannulation difficulty between 1993 and 1997 were reviewed. The following data were collected on each of these patients : primary disease, indication for tracheostomy, site of stenosis, endoscopic findings of stenosis, surgical techniques used for treatment. Results : Primary diseases were 30 head trauma, 4 neck injury, 10 other diseases. Indication for tracheostomy were 37 prolonged intubation, 4 emergency tracheostomy, 3 laryngeal trauma. Endoscopic findings of stenosis were 24 granulation tissue, 16 laryngotracheal collapse, 4 combined with granulation tissue and collapse. Site of stenosis were 3 glottic, 9 subglottic, 24 stomal, 1 substomal, 7 mixed. 22 of 24 cases were decannulation using endoscopic treatment. Conclusion : The most common cause of failed decannulation was sternal granulation tissue. The most effective treatment of granulation tissue was endoscopic technique.

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