• Journal of Chest Surgery
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• 제27권2호
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• pp.136-139
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• 1994

Tracheal stenosis is relatively common complication after tracheal intubation or tracheostomy for a long time. We experienced 10 cases of tracheal stenosis with various causes, prolonged intubation or tracheostomy caused the tracheal stenosis in seven, one after advanced cancer of the lung, one after inhalation burn, and the other was palliative management for tracheal stenosis by Gianturco type tracheal stent. We tried to correct this stenosis applying three tracheal stent and one Montgomery T-tube as a palliative approach, but failed in two, one restenosis due to regrowing of granulation tissue with scarring or another metastatic spread of cancer to systemic organs after 3 months of placing the stent. Tracheal circumferential resection and end to end anastomosis were done in seven, and obtained one postoperative complication as subglottic stenosis was followed by Montgomery T-tube and reoperation later. With the brief review of references, we report the cases.

• Journal of Chest Surgery
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• 제55권1호
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• pp.88-90
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• 2022

Tracheo-innominate artery fistula (TIF) is a rare, life-threatening complication of tracheostomy that makes it difficult to secure the airway due to massive bleeding, constituting a medical emergency. Therefore, most successful surgical treatments include innominate artery debridement and tracheal fistula repair. Herein, we report a case of successful surgical treatment of a TIF while maintaining cerebral blood flow through an artificial vascular graft.

• 한국임상수의학회지
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• 제40권2호
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• pp.124-129
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• 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.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.284-285
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• 2014

• 기본간호학회지
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• 제6권2호
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• pp.255-266
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• 1999

This study was done to analyze the effects of a smear in the nasal cavity against nosocomial Infection. The smear used was mupirocin, and the study centered on infection which constitutes the majority of nosocomial infections called MRSA. The data were collected between March 23 1998 and June 31 of the same year in a university hospital in the Kyongi Province, and is made up of a experimental group of 14 patients who were given nasal cavity smears and a control group of 16 patients who were not given nasal cavity smears. The data were analyzed through frequency and the Chi-square tests and gave forth these results. 1. Of the experimental group 28.6% developed nosocomial infections while 62.5% of the control group developed infections. This difference was significant. 2. In the experimental group, all of the patients developed infections within the first week in the ICU, while 80% of the control group developed infections in the first week and 20% in the second week. The difference was not as marked here. 3. In the experimental group the DM group 66.7% contracted MRSA while 18.2% developed it in the non-DM group showing that the DM group had infection rate was 3.7 times higher than the non-DM groups. In the control group the DM group had a 100% infection rate while 50% of the non-DM group developed it. Overall the DM group's rate infection was 2.4 times higher than the non-DM group. 4. In the experimental group, 37.55% of the patients who had a tracheostomy developed it while 16.7% of the patients who did not have a tracheostomy developed infections. In the control group, 62.5% of the patients who had tracheostomy, and 37.5% of the patients who did not have tracheostomies developed infections. Those who had tracheostomies, and the control group had double the rate contracting infections. From these results we can see that nasal cavity smears are effective against nosocomial infections. In spite of the smears, patients with the diabetes mellitus had a high MRSA infection rate, which requires new alternative treatments.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2439-2443
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• 2016

Purpose: To determine the risk factors, clinical symptoms and patterns of spread in laryngeal cancer. Materials and Methods: A cross sectional study was carried out in the Regional Cancer Centre, Imphal, Manipur, India. One hundred and sixteen patients with laryngeal cancer were retrospectively reviewed for epidemiological data and descriptive statistics were reported for various variables. Results: Median age at presentation was 65 years and 32.8% were undernourished at presentation. The male to female ratio was 5.4:1. Heavy smoking and tobacco chewing was associated in 91.4% and 33.6% of patients respectively. Tracheostomy was required in 21.5% leading to diagnosis of laryngeal cancer. Almost all were squamous cell carcinoma with neuroendocrine and verrucous carcinoma accounting for less than 2%. Supraglottic, glottic and trans-glottic tumors were 56.9%, 36.3% and 6.9% respectively. Nodal metastases were seen in 81.8% of supraglottic cancers and 31.6% of glottic cancers with supraglottic involvement. Level II neck nodes were the commonest site followed by level III. Distant metastases (only liver) were apparent in 1.7% at presentation. Including these liver metastases, unresectable cases were limited to 6% of the patients. Conclusions: Tobacco use is implicated in almost all of the cases and the sex ratio has also decreased due to increased female smokers. The supraglottis remains the commonest site and incidence of nodal metastases is higher than in other countries. There is also a higher requirement for tracheostomy at presentation in this region.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.349-353
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• 2008

Purpose: There are 3 well-known surgical procedures to treat Pierre Robin sequence: tongue-lip adhesion, distraction osteogenesis of mandible, and tracheostomy. The classical tongue-lip adhesion is an effective way to keep airway. The tongue, however, becomes quite non-mobile and appears dormant until the patient could control upper airway and the adhesion can be maintained for prolonged period. Most of all, this procedure does not provide the correction of the micrognathia. Distraction osteogenesis is a good technique to correct micrognathia and to prevent tracheostomies in patients with Pierre Robin sequence. But airway keeping procedure is needed during the distraction period. The purpose of this study is to determine the usefulness of temporary tongue-lip traction during the initial period of mandibular distraction in Pierre Robin sequence patients with severe airway problems requiring operative procedure. Methods: It was a prospective study of 2 Pierre Robin sequence patients aged between 4 months and 6 months requiring surgical procedure to correct recurrent and severe pulmonary complications. Two patients underwent distraction osteogenesis of mandible. During the operation, deep one tension suture was performed to tract the tongue and lip. When the patient gained control of upper airway at the initial period of distraction and micrognathia was corrected, the traction suture was removed. Results: All patients were followed up. No patients complained severe pulmonary complications and tracheostomy could be avoided. No patients had severe pulmonary complication. The pulmonary condition of patients was good. Conclusion: In severe Pierre Robin sequence case, temporary tongue-lip traction is a good assistant method in distraction osteogenesis because this method can avoid tracheostomy.

• 한국산학기술학회논문지
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• 제13권7호
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• pp.3030-3036
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• 2012

본 연구는 강제 양압식 호흡훈련이 기관절개관을 삽입한 뇌졸중 환자의 호흡능력 및 기침능력에 미치는 효과에 대하여 알아보고자 실시하였다. 연구대상은 기관절개관을 삽입한 뇌졸중 환자 10명으로 하였으며, 대상자는 강제 양압식 호흡훈련을 20분씩 주 5회 8주간 실시하였다. 훈련 전, 훈련 4주 후 그리고 8주 후 대상자의 노력성 폐활량, 1초간 노력성 호기량, 노력성 폐활량비 그리고 도수 보조 최대 기침유량을 측정하였으며 기간에 따른 호흡능력과 기침능력을 알아보고자 반복측정 분산분석법을 이용하였다. 연구 결과 훈련기간에 따라 대상자의 노력성 폐활량, 1초간 노력성 호기량, 도수 보조 최대 기침유량은 유의하게 증가하였다. 따라서 강제 양압식 호흡훈련은 기관절개관을 삽입한 뇌졸중 환자의 호흡능력 및 기침능력을 증진시켜 기관절개관을 제거하는데 유용한 훈련방법이라 할 수 있다.

• Journal of Chest Surgery
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• 제10권1호
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• pp.7-17
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• 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.

• 대한한방내과학회지
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• 제34권3호
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• pp.329-337
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• 2013

This is a case report of a tracheostomized 80-year-old man suffering from sputum after stroke. His symptoms were watery sputum production requiring frequent sputum suction. The subject was diagnosed as having a deficiency of spleen qi and was treated with Gami-ijung-tang, Yukgunja-tang, Soeumin Bojungikgi-tang, and Ijin-tang extract in the herbal prescription known to dispell Dam-eum (phlegm-retained fluid). Frequency of ssputum suction and condition of sputum were checked everyday. Gamiijung-tang, Soeumin Bojungikgi-tang with Ijin-tang extract led to improvement by reducing sputum secretion. There were limitations on frequency of suction and condition of sputum which were thought to be derived from tracheostomy, however. Consequently, pathology and treatment of sputum will be different whether tracheostomy was performed or not.