• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.77-80
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• 2018

Subglottic cysts have been reported as a relatively rare problem of pediatrics who have a history of premature birth and period of intubation. They may cause significant upper airway obstruction and many cases require tracheostomy to airway management. Endoscopic marsupialization by microinstruments or laser has been standard primary treatment but a high recurrence rate has been reported. A 19-month-old child presented with stridor who has history of ventilation via an endotracheal intubation in the newborn period for 7 days. Radiologic examinations were performed for aggravated dyspnea symptom and subglottic cystic mass was found, then it was marsupialized at operation room and tracheostomy was done at the same time. After decannulation of tracheostomy tube, there is no recurrence of cyst nor upper airway obstruction for 29 months. We report this case with a review of literature.

• 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 Korean Neurosurgical Society
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• v.39 no.6
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• pp.419-422
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• 2006

Objective : Endotracheal tube cuff-pressure[ETCP] increases significantly during anterior cervical spine surgery with neck retraction. Clinically, postoperative hoarseness with sore throat is correlated with vocal cord edema due to longer intubation time and higher ETCP during neck retraction. Methods : Fifty patients of anterior cervical spine surgery were randomized to a control [no adjustment, 25 cases] and a treatment group [ETCP adjusted to 20mmHg, 25 cases]. Patients were blinded to their group assignments. They were questioned about the presence of ischemic symptoms [sore throat, dysphagia, hoarseness] postoperatively at different time points; 4 hours, 24 hours, and 1 week postoperatively. Results : No differences between groups at 4 hours and 1 week postoperatively were demonstrated. At 24 hours, 36% of patients in the treatment group complained of sore throat while 56% of control group patients did [p < 0.05]. Female patients correlated with development of all ischemic discomfort [p < 0.05 : sore throat, hoarseness, dysphagia]. Conclusion : Our results suggest that postoperative ischemic symptom following anterior cervical spine surgery may be associated with the two predictors; increased ETCP during neck retraction and female. The simple procedure of maintaining ETCP to 20mmHg can prevent postoperative tracheal ischemic symptom.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.9.1-10
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• 1977

Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.279-285
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• 2005

One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.766-771
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• 1995

The trachea is defined as the airway from the inferior border of the cricoid cartilage to the top of the carinal spur. This paper would confirm the normal tracheal length of Korean adults through the actual measurement using the fiberoptic bronchoscopy. The subjects of this study were 25 patients, 13 males and 12 females between the age of 20 to 69 without abnormality on the neck, trachea, mediastinum and lung pharenchyme on the preoperative chest X-ray, who received the operations from the period of July to September, 1994. For those patients who had heart diseases, the cardiothoracic ratio was below 50%. The measurement was performed on the patients with endotracheal intubation under the general anesthesia in supine and neutral position. The tracheal length was calculated by the difference between the length from the tip of the endotracheal tube [E-tube to carina and to the needle which was inserted into the E-tube at the lower border of the palpated cricoid cartilage, by inserting the broncoscopy through the E-tube. The result was as follow : 1 The measured tracheal length for men was 11.8 0.2 cm[mean standard deviation and women was 10.5 0.3 cm, and that was longer than this [p<0.01 . The average was 11.2 1.0 cm and the standard error was 0.20 cm. 2 According to the correlation between the tracheal length to weight, height[Ht , age, and body surface area[BSA respectively, the Ht [p=0.003 , age [p=0.055 , and the BSA[p=0.017 were significant, while weight was not [p=0.314 . 3 From the regression analysis of the tracheal length[T.L. to the Ht, Age, and the BSA which were significant, the following equation was derived.i Ht : T.L.= -1.29 + 0.076 x Ht [P=0.003 ii Age: T.L.= 10.04 + 0.028 x Age [P=0.055 iii BSA : T.L.= 5.60 + 3.48 x BSA [P=0.017 iv In multi-regression : T.L. = -4.15 + 0.034 x Age + 0.085 x Ht [P=0.0002]

• Journal of Chest Surgery
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• v.54 no.3
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• pp.206-213
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• 2021

Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques. Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. The surgical method was determined based on the size of the fistula observed within the endoscope. Results: TEF occurred in 7 patients (87.5%) after intubation or tracheostomy and in 1 patient (12.5%) after esophageal surgery due to conduit necrosis. For tracheal management, 5 and 2 patients underwent tracheal resection and end-to-end anastomosis and primary repair, respectively. The median length of resection was 2.5 cm (range, 1.3-3.4 cm). For esophageal management, 6 patients underwent primary repair and 1 patient underwent esophageal diversion. One patient underwent TEF division with a stapler. Interposition of a muscle flap was performed in 2 patients. TEF recurrence, esophageal stenosis, and dehiscence or granulation occurred in 1, 1, and 2 patients, respectively. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. Conclusion: Although TEF surgery is complex and challenging, good results can be achieved if surgical standards are established and experience is accumulated.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.49-59
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• 2009

Purpose: Examination was done of the effects on unplanned extubation, oral mucosa, and facial skin integrity in patients with oral intubation secured with a new method using Multifix Endo II. Methods: A prospective quasai-experimental design was used. Data were collected during a 3-week EICU admission period between Jun. 1 and Nov. 30. Two hundreds seventeen (conventional taping group: 105, Multifix Endo II group: 112) orally intubated adults were enrolled in the study at the EICU of the C University Hospital. Results: The incidence of unplanned extubation (${\chi}^2=11.580$, p=0.03) and scores for the facial skin integrity impairment of the Mutifix Endo II group (t=5.28, p=.000) were significantly lower than those of the conventional taping group even though the scores for oral mucosa impairment were not different. The nurse's evaluation of the clinical effectiveness of the two methods including convenience, comfort, safety, and satisfaction were also higher for the new securement method compared to the conventional taping group. Conclusion: The securement method using Mutifix Endo II was more effective than the conventional method in the prevention of unplanned extubation and maintenance facial skin integrity.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.496-496
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.503-506
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.