• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.101-104
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• 2003

One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

• Tuberculosis and Respiratory Diseases
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• v.64 no.3
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• pp.206-209
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• 2008

Tracheal tuberculosis is a relatively uncommon form of tuberculosis and can result in acute tracheal obstruction early in the disease course. This is a report of a case of tracheal tuberculosis with unusual clinical presentation.

• Tuberculosis and Respiratory Diseases
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• v.77 no.5
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• pp.215-218
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• 2014

Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.407-412
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• 1994

Congenital long-segment tracheal stenosis which involves nearly entire trachea and carina is very rare disease, but leads to life threatening obstruction in infancy and childhood. Symptoms are ranged from stridor and wheezing to severe cyanosis and respiratory failure. Routine chest X-ray is somewhat helpful to diagnose it, but definitive diagnosis can be made by bronchoscopy or tracheogram for severely narrowed tracheal lumen.Recently, we experienced a case of congenital tracheal stenois, type 1 by Cantrell classification with carinal involvement. After costal cartilage was designed as oval shaped flap and covered with pericardium, anterior and posterior augmentation was done with prepared costal cartilage.This patient died of respiratory failure at 13 days postoperatively, probably due to sustaining obstruction in association in with failure to make a sufficient widening at carinal level.Important issues in the management of congenital tracheal stenosis are rapid diagnosis, selection of appropriate surgical procedure, and detailed anesthetic schedule.In the future, more biocompatible material and more effective surgical procedures should be studied to reduce the surgical mortality and morbidity of the complicated tracheal stenosis.

• Korean Journal of Bronchoesophagology
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• v.10 no.2
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• pp.17-21
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• 2004

Background Insertion of tracheal stent in the treatment of benign tracheal & bronchial disease has increased since the introduction of expandable metallic stent. Material & Methods : Between Jan, 1995 and Feb. 2004, eight patients who had benign tracheo-bronchial disease underwent insertion of expandable metallic tracheal stent. We retrospectively analyzed stent insertion indications, complications, and following the result. Results : Surgical indications were post-intubation tracheal stenosis (1 case), tracheal stenosis following tracheal surgery (2 cases), tracheo-esophageal fistula (2 cases), broncho-pleural fistula(1 case), left main bronchus stenosis following bronchoplasty (1 case), and left main bronchus stenosis due to mediastinal repositioning (1 case). Expandable metallic tracheal stent was inserted in five patients to resolve dyspnea caused by airway obstruction, and to prevent recurrent pneumonia in three patients. The complication developed in 6 patients $75\%$; 3 cases of distal stenosis due to growth of granulation tissue, and one case each of tearing of posterior membrane, aggravation of tracheo-esophageal fistula, and airway partial obstruction due to stent migration. The stent was removed in 5 patients and tracheal surgery (tracheal resection and end to end anastomosis with primary repair of esophagus, pericardial patch tracheo-bronchoplasty, tracheal repair and omental wrapping) was performed in 3 patients. Conclusion Insertion of self expandable metallic stent in benign tracheo-bronchial disease is an effective means of relieving dyspnea for only a short period, and it did not increase the long term survival. Better means of treatment of benign tracheo-bronchial stenosis in necessary.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.61-69
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• 1997

A total of 55 patients underwent surgical managements for postintubation tracheal stenosis from July 1975 through March 1997. All but 8 had received ventilatory assistance. The patients had S cuff lesions, 17 stoma lesions, 7 at both levels, 5 at subglottic lesions. Thirty two patients underwent the sleeve tracheal resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Twenty two patients received the Montgomery T-tube for relief of airway obstruction. Simple excision of granulation tissue was done in 7 patients. Rethi procedures(anterior division of cricoid cartilage, partial wedge resection of lower thyroid cartilage and T-tube molding) were performed in 2 subglottic stenosis patients. And the other subglottic patient was received permanent tracheal fenestration at 1975. The tracheoesophageal fistula patient was done sleeve tracheal resection and end-to-end anastomosis with interrupted double layer closure of esophageal fistula site. Cervical approach was used in 49 cases, cervicomediastinal in 13 cases and median stemotomy In 6 cases. Techniques for obtaining tension-free anastomosis included a cervical neck flexion(15-30$^{\circ}$) in all sleeve resection patients and laryngeal release in one. The length of resection was 1.5 to 5.0 on A total of 41 patients(74.5%) had good(24 patients) or satisfactory(17 patients) results. But in ten cases, the restenosis of anastomosis site which is the most common complication was developed Two of them underwent a second reconstruction and 8 patients required T-tube insertion for airway maintenance. Three patients(5.4%) died. The causes of death were tracheo-innominate artery fistula(2) and sudden obstruction of airway(1).

• Journal of Chest Surgery
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• v.21 no.2
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• pp.389-394
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• 1988

The patient was 22-year old male who had been suffered from labored breathing. Computerized tomography, tracheoscopy, tracheogram disclosed tracheal obstruction by external mass compression on Tl level, which ranged 4.Oem in the length and approximately 4mm in diameter on tracheogram. Under the local anesthesia, tracheostomy was done to prevent intraoperative airway obstruction. And general anesthesia, low collar incision 8z extended median sternotomy was made and nearly total thyroidectomy was performed. After the circumferential resection of the obstructed segment approximately 4cm in length[7 tracheal rings], direct end-to-end anastomosis of trachea was performed. Postoperatively, the patient`s neck was maintained in flexion state to reduce tension of anastomotic site. Postoperatively. medical therapy[Comthyroid k Calcium lactate] and radiotherapy were done. At present, 2-months after operation, he lives well.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.47-52
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• 2017

Anaplastic thyroid cancer is a rare disease entity consist 2% of whole thyroid cancer but once diagnosed, it is too fatal to survive. Airway obstruction is a leading cause of death in anaplastic thyroid cancer, which may be caused by both vocal cord palsy, mass effect of the cancer or direct invasion of the cancer itself to the tracheal lumen. Tracheal stent insertion can be a solution for airway compromised cases where surgical excision cannot be performed. The advantage is that the airway problem can be solved without invasive procedure. In this case, we tried expandable tracheal stent insertion for 66 years-old man with anaplastic cancer who visited ER for small amount of hemoptysis and dyspnea. There was severe tracheal narrowing and deviation due to the anaplastic thyroid cancer, ECMO (Extra Corporal Membrane Oxygenation) was used instead of a tracheal intubation for general anesthesia.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.104-112
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• 2005

Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.137-147
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• 1997

The rarity of primary tumor of the trachea, which was recently estimated in a circumscribed population to be 2.7 new cases per million per year, explains the relatively limited experience that has been acquired even by major institutions. Although there may already by a high degree of airway obstruction, tracheal tumors are usually misdiagnosed as bronchial asthma or chronic bronchitis because of its nonspecific symptoms. Surgery is the treatment of choice. Recently, the authors experienced three cases of primary tracheal malignant tumors ; one case of mucoepidermoid carcinoma and two cases of adenoid cystic carcinoma. The authors report on these cases with a review of the literature for give help in differential diagnosis and treatment planing of tracheal tumor.