• Title/Summary/Keyword: tracheal collapse

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Evaluation of Modified Extraluminal Prostheses Applied to the Trachea in Dogs (개의 기관에 적용한 변형제작한 기관외보철물의 평가)

  • 이충호;우흥명;권오경;남치주
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.1-7
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    • 1999
  • The purpose of the present study was to evaluate the easiness of suture and fixation of modified total ring prostheses (m-TRP). Twelve healthy dogs (B.W.2-10 kg) were randomly assigned to three groups. In group A (3 dogs), total ring prostheses was fixed by penetrating a suture material through tracheal mucosa. In group B (3 dogs), TRP was fixed by suturing on tracheal cartilage and muscular layer not penetrating through tracheal mucosa. m-TRP was applied to the cervical portions (group M-C,3 dogs), and thoracic portions (group M-T,3 dogs). Operating time of group M-C (37.33$\pm$6.80 min.) was shorter than those of groups B (83.33$\pm$8.50 min.) and A (63.33$\pm$11.06 min.) (p<0.01). Clinical complications were minimal and limited to mild, short-term hematoma, vomiting, edema, and inflammation. Coughing remarkably decreased in group B rather than group A. Dyspnea was not showed in group A, B, and M-C, but group M-T had a mild dyspnea. Gross postmortem findings were similar in all groups. Mild adhesions were present between prostheses and adjacent structures, but tracheal lumen was clean. Severe adhesions were present where m-TRP had been applied in the thoracic portions. Histopathologic abnormalities included mild to moderate adventitial and periprosthetic fibrosis and mild adventitial inflammation. The present study indicated that m-TRP were easier in suture and fixation than TRP and had no differences in support for trachea and side effects.

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Effectiveness of Endoscopic Dilatation & Silicone Stent Insertion for Tracheobronchial stenoses : Preliminary study (기관-기관지 협착에서 내시경적 확장술 및 실리콘 스텐트의 유용성 : 예비보고)

  • Lee, Kyong-Soo;Park, Dong-Wook;Kim, Kyu-Hun;Kim, Jae-Wook;Koh, Yoon-Woo;Kim, Do-Jin;Lee, Seung-Won
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.50-55
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    • 2009
  • Objectives: Endoscopic airway dilatation and stenting has been developed to treat the airway stenosis without potential morbidities of open surgery. We report the clinical results of endoscopic airway dilatation with silicone stenting in patients with posttuberculous bronchial stenosis(PTBS) and with severe main tracheal stenosis who have poor general conditions Methods : A prospective observation study of five patients, who have undergone endoscopic airway dilatation and silicone stenting between Feb 2007 and Feb 2009. A total of twelve patients were treated with endoscopic airway dilatation, among them 5 patients were included in this study. three patients were treated with newly designed silicone stent (Natural stent: TNO Co., Seoul, South Korea) because of poor surgical conditions and longer stenotic segment Results: 3 patients were grade III PTBS, and the other 2 patients were grade IV post tracheotomy main tracheal stenosis. One patient of PTBS were treated with silicone stent following endoscopic dilatation because of longer stenotic segment. Two patients of main tracheal stenosis patients were treated with silicone stent because of tracheal lumen collapse. There was no severe postoperative complications except mild granulation tissue formations Conclusions : Endoscopic dilatation including silicone stenting could be a useful method for treating patients with PTBS, and for main tracheal stenosis patients with poor general surgical conditions

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A Rare Case of Tracheomalacia Associated with Vascular Ring in an Infant

  • Han Seok Joo;Sung Tae Yon;Lee Kyo Jun;Choi Hong Sik;Shim Yon Hee;Nam Yong Taek
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.63-67
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    • 2004
  • Tracheomalacia can be a life threatening upper air way obstructive disease in an infant and vascular rings can be also a major rare cause of tracheoesophageal obstruction. These two rare entities can be combined in one patient because the vascular ring can cause secondary tracheomalacia during development of fetus. The diagnosis of this combination and adequate surgical correction is occasionally difficult. This is a report of an infant who had not diagnosed tracheomalacia associated with vascular ring until 5 months of age because of the prolonged tracheal intubation. The rigid bronchoscopic examination performed under impression of tracheomalacia revealed a concentric tracheal collapse, an unusual bronchoscopic findings of tracheomalacia, which raised a suspicion of the tracheal compression by vascular rings. The 3-D reconstructive DT aortography clearly demonstrated the double aortic arch. The patient was treated surgically by simple division of the left aortic arch and aortopexy with good result. The vascular ring such as double aortic arch should be considered during the diagnosis of tracheomalacia in infants. If the tracheomalacia is associated with vascular ring, simultaneous surgical correction should be performed.

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Decannulation Difficult (기관 캐뉼 발거 곤란증)

  • 봉정표;임구일;유기원;이준규;박성원;홍기수
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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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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Intratracheal Stenting Under the Aid of Transcutaneous Cardiac Pacing in a Dog with Severe Bradycardic Conduction Defect (중증 서맥성 전도장애 개에서 피부경유 심박 조절 하에 기관내 스텐트 장착)

  • Lee, Seung-Keun;Hyun, Chang-Baig;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.400-404
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    • 2008
  • A 10-year-old intact female Yorkshire terrier dog (weighing 3 kg) was referred with the primary complaint of severe dyspnea, cyanosis and occasional syncopal episode. Physical examination revealed irregularly irregular bradycardia with persistent pulse deficits. The 12-lead surface ECG showed high grade atrioventricular blocks. Thoracic radiography revealed severe intrathoracic collapse. The dog was successfully treated with an intraluminal self-expanding stent ($COOK^{(R)}$) under the aid of transcutaneous cardiac pacing.

Artificial Trachea Covered by Ipithelium (상피세포 피복 인공기관의 개발)

  • 김광택;이윤신
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.739-746
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    • 1997
  • A variety of experiments concerning the development of ideal prosthetic grafts for correcting circumferential tracheal defects have been performed. The requirements for an ideal tracheal prosthesis are impermeability to air, consistency to prevent collapse, and acceptance by the host tissue causing a minimum inflammatory reaction, allowing fibroblastic infiltration and epithelialization. The synthetic material, polyurethane(PU), is known as a biocompatible polymer with an inert component. In this study, the tracheal prosthesis was made from microporous PU(30 micrometer in diameter) coated with gelatin and reinforced with isoplastic rings. This procedure provides the prosthesis with a compression strength. The out side diame er of the prosthesis was 20 mm with a length of 30 mm. The gelatin used in the study was obtained from pig skin and immobilized and cross-linked by irradiation(60 Co gamma ray) to promote host tissue incorporation and render the prosthesis epithelization after implantation. Animal experiments using 10 mongrel dogs were performed to compare three kinds of prosthesis; gelatin coated polyurethane graft, uncoated polyurethane graft, and prosthesisf pericadium complex graft. After 6 weeks of implantation, the epithelialization of implants was seen on the gelatin-coated and prosthesisfpericadium complex grafts. Implanted prosthesis were complicated by airway obstruction due to anastomosis granuloma. Early tracheal stenosis was found in the uncoated graft group. Two kind of anastomosis techniques were tested on the gelatin-coated prosthesis. Everted anastomosis resulted severe granuloma than the inverted anastomosis. In the prosthesislpericadium complex graft, bacteria and inflammation at a anastomotic site was found. Based on these results, gelatin coated porous polyurethane trachea prosthesis is biocompatible and may be useful in clinical application with further investigation.

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A Case of Subglottic Cancer with Saber Trachea (칼집형 기관을 가진 성문하부암 환자 1례)

  • Kang, Jeong Wook;Jung, Ah Ra;Eun, Young-Gyu;Lee, Young Chan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.41-43
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    • 2018
  • "Saber-sheath" trachea is a deformity of lower cervical or intrathoracic trachea. The configuration of the deformity is marked coronal narrowing associated with sagittal widening. This deformity is associated with chronic obstructive pulmonary disease. We report a case of patient with saber-sheath who underwent total laryngectomy. Although the patient had no tracheal collapse after the total laryngectomy, crusted discharge was increased. Diagnosis of the saber-sheath trachea, possible causes, and clinical implications are discussed.

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

  • 정동학;송승용;윤정선;정영석
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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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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Heart-base Tumors in Three Yorkshire Terriers (세 마리 개에서 발생한 심저부 종양 증례)

  • Kwon, Jeong-Kuk;Chung, Woo-Jo;Jang, Ju-Won;Kim, Young-Il;Chung, Dae-Won;Jeoung, Seok-Young;Chung, Jin-Young
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.303-306
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    • 2014
  • Three Yorkshire Terriers (12-year-old, 13-year-old, and 15-year-old castrated males) with respiratory distress, coughing and anorexia were the subjects of this report. In laboratory examinations, there were no remarkable findings. However, the thoracic radiographic findings included a large mass of soft tissue density in the cardiac base region, tracheal elevation, and aortic bulging in all three Yorkshire Terriers. There were no remarkable findings in the abdominal radiographs. In echocardiography, a homogeneous hyperechoic mass around the aorta and bicuspid valve regurgitation were found in all three dogs. There were no remarkable findings in abdominal ultrasonography. Computed tomographic findings showed a large well -defined heterogeneous mass in the cranial vena cava, which was dominant in the left side in all three Yorkshire Terriers. The mass sizes were about $3{\times}4cm$. In post-contrast scanning, contrast enhancement was evident. These cases were diagnosed as heart-base tumor. Treatments provided to the three dogs were based on symptomatic medical management of cardiac failure and tracheal collapse. Case 1 (12-year-old) survived for 3 months, case 2 (13-year-old) for 5 months, and case 3 (15-year-old) for 32 months after the diagnosis. Our results show that the clinical findings, thoracic radiography, echocardiography, computed tomography (CT) and symptomatic medical management in dogs suspected to have heart base tumor.