• Title/Summary/Keyword: Tracheal surgery

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CT Measurement of Diameter and Dimension of the Trachea in Normal Korean Adults (흥부 전산화단층촬영을 이용한 한국성인의 기관내경과 단면적의 측정)

  • Han, Jae-Youl;Kim, Kwang-Ho;Lee, Gun;Kim, Hyung-Jin;Cho, Soon-Koo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.534-538
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    • 2001
  • Background: Knowledge of size and morphology of the normal trachea is important for airway management and tracheal reconstruction. Conventional radiography is a simple method used to measure the tracheal diameter, but it is not accurate because of the artifacts related to image magnification and overlapping by the shoulder. The purpose of this study was to provide the normal values of the tracheal size and anatomy in Korean adults using Computerized Topography. Material and Method: There were 43 men and 34 women included in this study. They were divided into three age groups(group 1, 20-39 years ; group 2, 40-59 yeas , groups 3, $\geq$60 years). The anteroposterior and transverse diameters and cross - sectional areas of the trachea were measured at the level of the thoracic inlet(Level 1) and the aortic arch(Level 2). These values obtained at each level were compared between age groups and sexes. Result: In 43 men, the anteroposterior / transverse diameters(mean SD in millimeters) of the trachea at levels 1 and 2 were 19.95$\pm$2.99 / 17.72$\pm$2.13 and 19.77$\pm$2.57 / 18.02$\pm$2.19, respectively. In 34 women, those values at levels 1 and 2 were 15.56$\pm$2.12 / 14.18$\pm$2.07 and 15.35$\pm$1.82 / 15.00$\pm$1.60, respectively. At both levels, the anteroposterior and transverse diameters were significantly greater in men than in women (p<0.05). The cross-sectional area of the trachea at levels 1 and 2 were 279.14$\pm$61.37 / 281.93$\pm$63.97 $\textrm{mm}^2$ in men and 173.29$\pm$35.81 / 181.88$\pm$34.74 in women, respectively. They also showed significantly greater values in men than in women(P<0.05). There was no significant difference in diameters and cross-sectional areas of the trachea between age groups. Conclusion: There are significant differences in the internal diameter and cross- sectional area of the trachea between men and women in normal Korean adults, while the age difference was insignificant. We believed CT is a relatively accurate and safe way to measure the internal diameter and cross-sectional areas of the trachea.

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A Case of Giant Lobular Capillary Hemangioma in Glottis Causing Airway Obstruction (기도 폐색을 유발한 성문부 거대 소엽성 모세관 혈관종 1예)

  • Choi, Jeon Ha;Lim, Sung Hwan;Lee, Mi Ji;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.1
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    • pp.49-52
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    • 2016
  • The lobular capillary hemangioma (LCH) was previously known to pyogenic granuloma and is benign vascular lesion which grows rapidly on skin and mucosa. It arises from whole body, but oral and nasal cavities are most predilection sites in the head and neck area. The laryngeal LCH looks like a granulomatous lesion of posterior glottis and its common etiology are tracheal intubation and laryngopharyngeal reflux disease etc. The LCH in larynx can cause blood tinged sputum and lump sense. The lesions refractory to medical therapy or causing dyspnea may require surgical excision. A 74-year-old man who presented gradually aggravated dyspnea, lump sensation and hoarseness of one month came to our hospital. The stroboscopic examination revealed large well-margined glottic mass. It was excised with $CO_2$ laser and finally diagnosed as LCH. We present a rare unique case of glottic LCH with a review of literatures.

Cervical Bronchogenic Cyst (경부 피하조직내에 발생한 기관지성 낭종)

  • Kim Suk-Ju;Chung Woung-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.247-250
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    • 1997
  • Bronchogenic cysts are thought to be uncommon developmental anomalies. They develop from small buds or diverticuli that separate from the foregut in the formation of the tracheo-bronchial tree. They are nearly always located near the tracheal bifurcation; However, these lesions can occur anywhere along the tracheo-bronchial tree. We experienced a case of cervical bronchogenic cyst presenting sorely as an anterior neck mass in a 26-year-old woman. The neck ultrasonography showed as $1.4{\times}1.1cm$ sized hypoechoic lesion with a well-defined margin on the isthmic portion of the thyroid gland. Excision of the mass was carried out. The mass was superfical to the strap muscle and was contained within the subcutaneous tissue in the midline without any connection to the trachea. Grossly, the mass was an oval-shaped cystic lesion which measured 1.5 cm in the greatest diameter. The cyst was filled with thick, yellow, jelly-like material and the inner surface was smooth and glistening. Microscopically, the cyst showed a lining of ciliated columnar epithelium, beneath which was a loose areolar stroma containing plaques of mucous glands and mature cartilage. We thought this cervical bronchogenic cyst appeared to represent an expression of complete aberrent accessory lung bud detachment from the primitive foregut.

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Repair of Aortic Coarctation in Infants (유아기 대동맥교약증의 외과적 치료)

  • 전상훈
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.739-747
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    • 1989
  • Between September 1986, and August 1989, eight infants underwent operation for repair of coarctation of the aorta in the first year of life. The patients included 7 males and 1 female ranging in age 19 days and 9 months. Weights ranged from 3.5 Kg to 7 Kg [mean 5 Kg]. All patients had preductal coarctation of the aorta. Each infant had associated cardiac anomalies, including ventricular septal defect [7 infants] and patent ductus arteriosus [5 infants]. All had intractable congestive heart failure, despite aggressive medical therapy. Pressure gradient across the coarctation ranged from 10 mmHg to 60 mmHg. Operative techniques were subclavian flap aortoplasty in five cases, Gore-Tex patch aortoplasty in three cases. In addition to coarctation repair, six infants had concomitant banding of the pulmonary artery. Four infants required ventilator support for several days. There was no operative death. Complications developed in two. One infant had tracheal stenosis after a tracheostomy. Another infant had restenosis of the aorta revealed by cardiac catheterization 30 months after surgery. The pressure gradient was 30 mmHg, necessitating balloon dilatation aortoplasty. Results were satisfactory. During follow up, we performed total correction procedures [patch closure of the ventricular septal defect, infundibulectomy, pulmonary valvotomy and pulmonary artery angioplasty] in one case. Continuing follow-up finds all patients in good condition.

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Management of Thyroid Cancer with Laryngotracheal Invasion (후두와 기관을 침범한 갑상선암의 치료)

  • Kim Kwang-Hyun;Sung Myung-Whun;Roh Jong-Lyel;Chung Won-Ho;Kim Chun-Dong;Suh Jung-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.8-15
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    • 1996
  • When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

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Treatment of a Nail in the Intestine after a Neck Injury from Accidental Firing of the Nail Gun - A case report - (네일 건(Nail Gun) 사고에 의해 전경부 기도 손상은 있었으나 식도 손상 없이 장 내로 유입된 못에 대한 치험 - 1예 보고 -)

  • Yang, Jin-Sung;Shin, Hwa-Kyun;Lee, Jae-Wook;Won, Yong-Soon;Park, Young-Woo
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.675-678
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    • 2008
  • A 42-year-old male was admitted because of an anterior neck injury due to accidental firing of a nail gun. On chest X-ray, the nail was stuck in the anterior neck, migrated to the chest, and then to the abdomen. Only the trachea was damaged, leaving no injury in the esophagus. The nail in the intestine was removed by colonoscopy. The patient showed complete recovery without complications after fasting and conservative treatment. We report this case with a literature review.

Glomus Tumor of the Trachea - A case report - (기관에 생긴 사구 종양 - 1예 보고 -)

  • Lee, Chang-Young;Park, In-Kyu;Song, Seung-Jun;Chung, Kyung-Young;Kim, Kwan-Wook;Shim, Hyo-Sup
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.540-542
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    • 2009
  • Glomus tumor is a distinctive type of perivascular tumor whose cell type is a modified smooth cell that closely resembles the glomus body, and this is where the tumor's name is derived. This kind of neoplasm is a benign and rather uncommon neoplasm that can be found in any part of the body, yet it is most commonly seen in the subungual area. Glomus tumor of the trachea is extremely rare. We present the clinicopathologic findings of a resected glomus tumor of the trachea along with a review of the related literature.

A Successful Slide Cricotracheoplasty in Congenital Cricotracheal Stenosis (선천성 기관-윤상연골 협착에서 성공적으로 시행한 활주 기관-윤상연골 성형술)

  • Huh, Jung-Wook;Han, Seok-Joo;Kim, Young-Ho;Kim, Myung-Joon;Lee, Gee-Young;Kim, Jae-Eok;Han, Ai-Ri;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.54-58
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    • 2001
  • Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

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Atherosclerotic Aneurysm of the Right Proximal Subclavian Artery - A case report - (우측 근위부 쇄골하동맥에 발생한 동맥경화성 동맥류 - 1예 보고 -)

  • Kim, Duk-Sil;Kim, Sung-Wan;Kim, Byung-Ki;Lee, Hyeon-Jae;Lee, Gun;Lim, Chang-Young
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.649-652
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    • 2009
  • A 75-year-old man presented with worsening dyspnea and intermittent dysphagia of one month's duration. A plain chest X-ray showed severe tracheal indentation by the right superior mediastinal mass. A chest CT established the diagnosis of a saccular aneurysm arising from the right proximal subclavian artery. Resection of the aneurysm and arterial revascularization was done through a median sternotomy with supraclavicular extension. Aneurysm wall and thrombus culture results were negative and pathology showed an atherosclerotic aneurysm. After the operation, dyspnea and dysphagia were reduced, but he died of advanced stomach cancer 8 months later.

Laryngotracheal stenosis in burn patients with inhalation injury (흡인화상환자에서 발생하는 후두 및 기관 협착)

  • Park Il-Seok;Chang Jai-Hyuk;Kim Beom Gyu;Kim Yong Bok;Rho Young Soo;Ahn Hwoe Young;Kim Jong Hyun
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.10-14
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    • 2005
  • Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

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