• 대한기관식도과학회지
• /
• 제13권1호
• /
• pp.29-32
• /
• 2007

Background and Objectives: Improvements in the fields of neonatology and surgical subspecialities make tracheotomy possible to the younger population. But complication rates for infantile tracheotomy are significantly higher than that for the other pediatric tracheotomy. This study was designed to present our 9-year experiences of infantile tracheotomy and to evaluate the effect of several factors of complications. Materials and Methods: From 1996 through 2004, 60 tracheotomies were performed. Charts were reviewed with respect to indications for tracheotomy, underlying diseases, success rate in decannulation and length of support time until decannulation, complication and mortality rate. Results: There were 41 male patients and 19 female patients. Ventilatory support for neurological impairment(38.3%) was the leading indication for tracheotomy, followed by subglottic stenosis(36.7%), laryngomalacia(13.3%). Decannulation was accomplished in 60.0% of infants with an average of 56.5momths with tracheotomy. Complications occurred in 43.3%. There was one tracheotomy-related mortality in case of tracheal atresia. Most common complication was subglottic stenosis. Conclusion: Infantile tracheotomy had significant morbidities and its outcomes are thought to be usually related to the underlying disease and age. To prevent complication, early decannulation is advisable, and for long-term tracheotomy patients, regulation of reflux and infection may be necessary.

• 대한기관식도과학회지
• /
• 제3권2호
• /
• pp.261-269
• /
• 1997

When performing an endotracheal intubation or tracheotomy to an unconscious patient in emergent situations, one should consider the possibility of later complication of laryngo-tracheal stenosis which can result in difficulties in decannulation. Laryngo-tracheal stenosis is a bothersome problem developing as a complication of treatment by tracheotomy with a cuffed tube and long-term endotracheal intubation with assisted ventilation. One hundred twenty-three cases of laryngo-tracheal stenosis patients during the four yew period from May 1992 to April 1996 were restrospectively reviewed according to several parameters such as the duration of intubation, site of stenosis, treatment modality and, site of tracheostoma. The present report is an analysis of these materials to search for the possible etiologic factors and its proper preventive methods. It was desirable that the endotracheal intubation should be limited within 20 days at most. Tracheotomy performed by non-otolaryngologists has a tendency to be on a higher level of trachea. Technical precautions should be taken into consideration when doing a tracheotomy. The success rate of decannulation of tracheal T-tube was 78.8% and it required average 11 months.

• 대한기관식도과학회지
• /
• 제4권1호
• /
• pp.35-42
• /
• 1998

The complications of a tracheotomy are caused by inappropriate surgical techniques, unsuitable cannula selections, and improper wound care. Among these, the solutions to problems of surgical technique and wound care have been reported in many articles. Detailed methods for preventing complications by the cannula are rare. The authors tried to find a way of preventing complications by the cannula Materials and Methods : The authors analized complications in 70 patients who had a temporary tracheotomy and were wearing a cannula. And the complications were compared between 4 commercial cannulas used in our institute. The examination methods used were a simple neck lateral radiogram and flexible endoscopy. Results： The order of most commonly found complications were as followed; at the suprastoma, end of cannula, level of tracheotomy, and infrastoma. Among 4 cannulas, a particular product had so many complications compared to the other 3 cannulas. The most common cause of complications was unsuitable cannula. All complications were cured with no sequelae. Flexible endoscopy is far superior to radiologic exam for detecting tracheal complications. Conclusion： Flexible endoscopy through the tracheostoma is very helpful for detecting complications early and determining if a proper cannula is used, which can prevent further complications such as stenosis or innominate artery rupture. The authors, therfore, recommend using the flexible endoscopy to all patients wearing tracheotomy tubes. Some complications can simply be prevented by replacing the one to another cannula properly fit for the individual patients. Various cannulas should be prepared at the hospital because the tracheal curvature and distance of skin to trachea are individualized.

• 대한두경부종양학회지
• /
• 제32권1호
• /
• pp.21-23
• /
• 2016

The aim of this report was to present a rare case of a tracheotomy site recurrence after operation and post-operative radiotherapy in head and neck squamous cell carcinoma patient. Tracheotomy site recurrence other than subglottic cancer is very rare in head and neck cancer patient. The granulation tissue around tracheotomy was a fertile "soil" for tumor cell implantation. Midline mucosal sparing block which was used to decreased acute toxicity during post-operative radiotherapy could be facilitating the tumor cell implantation. The head and neck surgeon should try every effort to reduce contamination of cancer cells during operation and consider the entire operative field should be included in post-operative radiation portals.

• 대한두경부종양학회지
• /
• 제18권1호
• /
• pp.71-75
• /
• 2002

Background and Objectives: The tracheotomy is one of the most essential surgical procedures performed in the intensive care unit (ICU). The tracheal stenosis, as a complication following endotracheal intubation or tracheotomy, has been the subject of considerable recent investigation. Many different methods have been developed to avoid the tracheal stenosis but there is still controversy about the tracheal incisions. We had performed tracheotomy using a vertical elliptical tracheal incision in the ICU to evaluate its efficiency and safety. Materials and Methods: 191 patients who underwent the tracheotomy in the ICU between 1995 and 2000 were reviewed retrospectively by chart records and interviews. Results: The complications were reported such as bleeding, infection, subcutaneous emphysema, pneumothorax, tracheoesophageal fistula and tracheal stenosis. The total numbers of complications were 35 cases (18.3%) and the tracheal stenosis was developed in 4 patients. The characteristics of tracheal stenosis are as follows. Conclusion: The vertical elliptical tracheal incision is the safe and reliable methods in ICU patients compared with other methods, but other factors are also important in preventing the complications.

• 대한후두음성언어의학회지
• /
• 제10권2호
• /
• pp.149-153
• /
• 1999

Relapsing polychondritis is an uncommon disorder of unknown etiology. That involves multisystem characterized by recurrent inflammation, degenerative change of multiple cartilaginous structures. The most common clinical manifestation is an auricular chondritis. Other involving systems are joint, nose, eye, larynx, trachea, aorta, heart and kidney. A 26-year-old man who complained of hoarseness and sore throat was referred to the ENT department from internal medicine department. On initial video-laryngoscopic and radiologic examination, there was no abnormal finding. Treatment with high doses of corticosteroid and methotrexate was not effective. Symptoms were aggrevated with dyspnea. Three months later, on video-laryngoscopic examination, bilateral cord fixation with swelling was noted. The radiologic finding showed subglottic stenosis due to collapse of anterior wall of cricoid cartilage. The condition was managed with tracheotomy. We report a case of relapsing polychondritis involving larynx and trachea with bilateral vocal cord palsy which was managed with tracheotomy.

• Clinical and Experimental Pediatrics
• /
• 제48권5호
• /
• pp.557-560
• /
• 2005

재태 연령 38주, 출생체중 3,040 g, 제왕절개로 출생하여 단 일제대동맥이 동반되고 첫 울음 없이 전신에 청색증, 심한 호흡 곤란이 발생하여 기관내삽관을 시행하였으나 실패 한 후 후두내시경을 통해 확진된 선천성 후두폐쇄증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한두경부종양학회지
• /
• 제27권1호
• /
• pp.92-95
• /
• 2011

The anterior mediastinal tracheotomy(AMT) facilitates resection of stomal recurrence after total laryngectomy and tumors involving the cervicothoracic trachea and esophagus. An 81-year-old-man came to our clinic due to the progressive dyspnea during three months. He received the total laryngectomy five years ago. We diagnosed as Sisson type I stomal recurrence and then performed the wide excision, both selective neck dissection, sternal manubrium resection and AMT. Before surgery, we planned the pectoralis major myocutaneous flap. Unluckily we could not fulfill this procedure because of patient's medical status during anesthesia. The tracheocutaneous fistula was observed in the second postoperative day. He expired due to the huge bleeding from the wound. When AMT is performed, exact manipulation of major vessels and adequate flap are mandatory these elevate the feasibility of AMT.

• 대한기관식도과학회지
• /
• 제11권1호
• /
• pp.32-36
• /
• 2005

This study aimed to report a case of infant who presented with a prenatal ultrasound diagnosis of agnathia, polyhydramnios followed by a review of previous studies. As widely acknowledge, agnathia is a complex lethal malformation characterized by absent mandible, microstomia, microglossia and ear anomaly which are secondary results to a defect of the first branchial auh. Newborn infants with agnathia often suffer from airway obstruction, causing fatal respiratory failure. The most difficult part of treating those newborns is to keep the airway patent. Therefore, as early airway management planning as possible is the most important part. Airway management was achieved with tracheotomy through an ex utero intrapartum treatment procedure(EXIT). The case of this infant, reporting here, was underwent tracheotomy with preservation of uteroplacental blood flow and gas exchange.

• 대한간호
• /
• 제9권1호통권45호
• /
• pp.17-21
• /
• 1970