• Journal of Veterinary Clinics
• /
• v.40 no.2
• /
• pp.124-129
• /
• 2023

A 5-year-old neutered male domestic short-haired cat presented with acute dyspnea characterized by open-mouth breathing and stridor for 2 days. Direct visualization via laryngoscopy revealed diffuse laryngeal swelling and severe thickening of the vocal folds bilaterally; thus, the upper respiratory tract was obstructed owing to severe edema. Neutrophil infiltration was found on fine needle aspiration of the larynx cytology, and no discrete mass with polyp or neoplasia was identified on diagnostic imaging. The cat was diagnosed with acute obstructive laryngitis, and a tracheostomy tube was immediately installed. After 17 days of treatment with steroids, doxycycline and azithromycin, the swollen larynx gradually improved, and there was no recurrence of laryngitis or respiratory obstruction. A feline upper respiratory polymerase chain reaction panel revealed Mycoplasma felis infection; however, it could not be determined whether it was pathogenic or opportunistic. Herein, we report a case of obstructive laryngitis in a cat. When respiratory obstruction due to acute laryngitis is identified, a good prognosis is expected with rapid and appropriate treatment.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.2
• /
• pp.40-44
• /
• 2007

Background and Objectives: Most of tracheal stenosis is resulted from longstanding endotracheal tube insertion. Treatments of tracheal stenosis are divided conservative and reconstructive treatment. The propose of this study was to evaluate the effect of prosthetic tracheal T-tube insertion on tracheal stenostic patients who can not be operated invasive surgery. Subjects and Method : Nine prosthetic tracheal T-tube insertion were studied from 9 patients from January 2002 to April 2007. The effect of silastic T-tube was analyzed according to the factors that were respiratory difficulty, oxygen saturation, phonation, aspiration and significant complications. Results: Four patients were good for respiration and no complication. But five patients occur various complications. A successful group did not have cartilagenous lesions but failed group had catilagenous lesions, infection and necrosis. Conclusion: A silastic T-tube insertion was good for palliative treatment in patients without catilagenous lesions.

• Korean Journal of Bronchoesophagology
• /
• v.18 no.2
• /
• pp.41-44
• /
• 2012

Acquired tracheoesophageal fistula (TEF) can occur rarely from various causes. Recently, cuff-related tracheal injury after endotracheal intubation with the orotracheal tube and tracheostomy cannula is the most common etiology of nonmalignant TEF. Since cuff-related TEF is usually preventable with proper selection of the cuffed tube and close monitoring of cuff pressure. Although most patients present increased secretions, recurrent pneumonia, or coughing after swallowing, a high index of suspicion is required in patients at risk for developing a TEF. Surgical correction for the defectis required. In most cases, primary closure of the esophageal defect and tracheal resection and end-to-end anastomosis give the best results.

• Journal of Chest Surgery
• /
• v.10 no.1
• /
• pp.7-17
• /
• 1977

The increasing frequency of post-tracheostomy stenosis parallels the increase in the incidence of tracheostomy. The development of stenosis of trachea following the operation of tracheal tumor or tracheostomy is a very serious complication. The continuing need for an adequate tracheal substitute has not been answered, despite the necessities of excision and reconstruction of the trachea to keep for effective ventilation. Experimental tracheal reconstuction, with a prosthesis of heavy Marlex mesh and pericardium, _ vas performed in twelve dogs. Five to six tracheal ring circumferential defects were created and were bridged with heavy Marlex mesh fashioned into a tube of suitable diameter. Group A: A prepared cylinder of Marlex mesh was anastomosed outside the cut ends of the trachea. Group B: The external surface of the prepared cylinder of Marlex mesh was completely covered with suitably sized patch of pericardium and overlapped all margin of the Marlex mesh by 2 to 3 mm in each direction. Group C: The internal surface of the prepared cylinder of Marlex mesh was covered with suitably sized patch of pericardium and overlapped all margin of the Marlex mesh by 2 to 3 mm in each direction. The results of this exepriment were as follow: 1. In group A and B, the graft was well bridged with new granulation and fibrous tissue, and the lumen of trachea kept good patency for effective ventilation.. The interstices of Marlex became uniformly infiltrated with young well vasculated connective tissue. Epithelization has not yet occurred at 4 weeks in each group, but there were evidences of new growing mucosa at grafted site in 6 weeks. The remainder of the prosthesis was completely covered with glistening epithelium and the underlying fibrous tissue became more matured with little inflammation. These findings were more striking in group B than group A. 2. In group C, the covered pericardium was necrotized with stenosis of the lumen of grafted site due to poor blood supply.

• Journal of Chest Surgery
• /
• v.10 no.1
• /
• pp.17-24
• /
• 1977

The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tube has produced, apparently with increasing frequency, three lesions which have serious ceminical manifestations such as tracheal stenosis, tracheomalasia, and localized tracheal erosion. Extensive resection and reconstruction of the trachea must be necessary because conservative treatment has generally failed in the fully developed stenotic lesion. of the mediastinal trachea following extensive resection is best accomplished by direct anastomosis of the patient`s own tracheobronchial tissue. Any replacement of the mediastinal trachea must be air tight and laterally rigid, and must heal dependably. A variety of materials has been used for substitution following circumferential excision of tracheal segments within the mediastinum. These attempts have often failed because of early leak or late stenosis. We have successfully performed circumferential resection and primary end-to-end anastomosis of the trachea for 4 cases of post-intubation tracheal stenosis located a few centimeter below the tracheostomy stoma in the period of 3 years between 1974 and 1976. The lesion in one patient was found in the upper trachea which was approached anteriorly through a cervicomediastinal incision with division of the upper sternum. Other three located in the lower half of the trachea were operated through a high transthoracic incision with appropriate hilar mobilization in addition to cervical flexion for the development of the cervical trachea into the mediastinum. There were no hospital death, but suture line granulations occurred in two patients were managed by bronchoscopic removal of granulations without difficulties.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1981.05a
• /
• pp.5.1-5
• /
• 1981

We have recently removed five interesting foreign bodies successfully. Case 1. A broken tracheostomy outer cannular tube in the right main bronchus of a 7 year old boy. Case 2. An acupuncture needle in the trachea of a fifty-one year old man. Case 3. A fish hook with thread in the second isthmus of esophagus of a 10 month old girl. Case 4. An opened safety pin (sharp point toward cephalad) in the third isthmus of esophagus of a sixteen year old boy. Case 5. A big lead bullet which went through soft tissue below right mastoid tip and lodged at the mid-point between right mastoid process and foramen magnum(skull base) of a twenty year old boy, was removed surgically uneventfully.

• Journal of Chest Surgery
• /
• v.29 no.11
• /
• pp.1288-1291
• /
• 1996

Tracheoinnominate artery fistula is a rare but a catastrophic complication after tacheostomy or tracheal reconstruction. We experienced one case of tracheoinnominate artery fistula after tracheal reconstruction. The patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. She complained of dyspnea and paroxysmal cough 5 months after tracheostomy and was diagnosed as tracheal stenosis. We performed 4cm of tracheal resection and end to end anastomosis. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and re-reconstruction of trachea. The patient died of bleeding 3 days after the reoperation.

• Korean Journal of Bronchoesophagology
• /
• v.4 no.1
• /
• pp.27-34
• /
• 1998

Despite improvement in respiratory care, including use of low pressure and high volume cuffed tubes, tracheal stenosis remains a serious complication after a long-term tracheal intubation and tracheostomy. In such patients, tracheal resection and primary anastomosis is still considered ideal therapeutic modality. Between 1989 and 1997, we performed tracheal resections with end-to-end anastomosis on 14 patients with no operative mortality and some morbidity. Tracheal stenosis was caused by tracheostomy in nine patients, by endotracheal intubation in three patients and by thyroid carcinoma in two patients. The length of stenosis was various from 2cm to 4.5cm. All patient underwent segmental tracheal resection and primary anastomosis(14 patients) and additional procedures were cricoid cartilage reconstruction(2 patients), suprahyoid laryngeal release(3patients), carinal release technique(2 patients) and arytenoidectomy(2 patients). We have nine complications: granulona at anastomosis site in four patients, vocal cord palsy in two patients and restenosis, pneumonia, skin necrosis in each of those patients. The granuloma was removed by bronchoscopic forceps(4 patients). Vocal cord palsy was treated by arytenoidectorny(2 patients), restenosis by T-tube insertion, pneumonia by antibiotics and skin necrosis was treated by skin graft. We reviews our expenence of clinical features of tracheal stenosis and surgical treatment by tracheal one-to-end anastomosis with additional procedures to avoid postoperative complications for sucessful results.

• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1142-1144
• /
• 1997

A case of fatal hematemesis due to an aberrant right subclavian arterioesophageal fistula which is a rare complication of the vascular ring is presented. A 42-year-old man with multiple injury by traffic accident presented severe upper gastrointestinal bleeding and was taken emergent operation. He was keeping tracheostomy tube and nasogastric tube for 7 weeks. We could find an aberrant right subclavian arterioesophageal fistula through left thoracotomy which was made by irritation of the prolonged nasogastric ube. We carried division of the aberrant right subclavian artery and fistulectomy. He was doing well postoperatively. But massive bleeding occurred at the fifth postoperative day. We performed emergent reoperation at CCU and found the tear point on the suture site of the aorta, which might be developed due to irritation of the chest tube andfor infection of the surrounding tissues. He was expired at the 8th postoperative day due to ischemic brain damage.

• Korean Journal of Bronchoesophagology
• /
• v.8 no.1
• /
• pp.61-65
• /
• 2002

Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.