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Published in: Current Anesthesiology Reports 2/2016

01-06-2016 | Thoracic Anesthesia (T Schilling, Section Editor)

Breathing Through a Straw: Considerations for Tracheal Stenosis Surgery

Authors: Nathaniel J. Brown, Ferenc Puskas

Published in: Current Anesthesiology Reports | Issue 2/2016

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Abstract

Tracheal stenosis can be a grave threat to patients’ lives. Absent invasive, and temporary, devices available only in intensive care units, the trachea is the only conduit for oxygen entering the body. Repairing tracheal stenosis requires advanced planning by both surgical and anesthesiology teams to ensure safety throughout the procedure. This paper aims to discuss key management highlights of tracheal stenosis from the preoperative stages through completion of surgery.
Literature
2.
go back to reference •• Windsor A, Clemmens C, Jacobs IN. Rare upper airway anomalies. Paediatr Respir Rev. 2015. An excellent overview of congenital tracheal issues that may require surgical intervention. This article extends into the pediatric population the treatment of tracheal stenosis that we present here. It is more focused on the medical management but will give a good flavor of what to expect clinically should you need to care for one of these patients. •• Windsor A, Clemmens C, Jacobs IN. Rare upper airway anomalies. Paediatr Respir Rev. 2015. An excellent overview of congenital tracheal issues that may require surgical intervention. This article extends into the pediatric population the treatment of tracheal stenosis that we present here. It is more focused on the medical management but will give a good flavor of what to expect clinically should you need to care for one of these patients.
3.
go back to reference Kapidzic A, et al. Postintubation tracheal stenosis. Med Arh. 2004;58(6):384–5.PubMed Kapidzic A, et al. Postintubation tracheal stenosis. Med Arh. 2004;58(6):384–5.PubMed
4.
go back to reference Grillo HC, et al. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg. 1995;109(3):486–92.CrossRef Grillo HC, et al. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg. 1995;109(3):486–92.CrossRef
5.
go back to reference Sandberg W. Anesthesia and airway management for tracheal resection and reconstruction. Int Anesthesiol Clin. 2000;38(1):55–75.CrossRef Sandberg W. Anesthesia and airway management for tracheal resection and reconstruction. Int Anesthesiol Clin. 2000;38(1):55–75.CrossRef
6.
go back to reference Nordin U. The trachea and cuff-induced tracheal injury. An experimental study on causative factors and prevention. Acta Otolaryngol Suppl. 1977;345:1–71.PubMed Nordin U. The trachea and cuff-induced tracheal injury. An experimental study on causative factors and prevention. Acta Otolaryngol Suppl. 1977;345:1–71.PubMed
7.
go back to reference Allen MS. Surgical anatomy of the trachea. Chest Surg Clin N Am. 1996;6(4):627–35.PubMed Allen MS. Surgical anatomy of the trachea. Chest Surg Clin N Am. 1996;6(4):627–35.PubMed
8.
go back to reference Salassa JR, Pearson BW, Payne WS. Gross and microscopical blood supply of the trachea. Ann Thorac Surg. 1977;24(2):100–7.CrossRef Salassa JR, Pearson BW, Payne WS. Gross and microscopical blood supply of the trachea. Ann Thorac Surg. 1977;24(2):100–7.CrossRef
9.
go back to reference •• Allen MS. Surgery of the trachea. Korean J Thorac Cardiovasc Surg. 2015;48(4):231–7. This article provides an excellent overview of the surgical anatomy of the trachea. It also gives the anesthesiologist a good view into many surgical concerns regarding tracheal surgery, thus enabling better communication. •• Allen MS. Surgery of the trachea. Korean J Thorac Cardiovasc Surg. 2015;48(4):231–7. This article provides an excellent overview of the surgical anatomy of the trachea. It also gives the anesthesiologist a good view into many surgical concerns regarding tracheal surgery, thus enabling better communication.
10.
go back to reference Bernstein WK, Deshpande S. Preoperative evaluation for thoracic surgery. Semin Cardiothorac Vasc Anesth. 2008;12(2):109–21.CrossRef Bernstein WK, Deshpande S. Preoperative evaluation for thoracic surgery. Semin Cardiothorac Vasc Anesth. 2008;12(2):109–21.CrossRef
11.
go back to reference Ko Y, et al. Changes in the flow-volume curve according to the degree of stenosis in patients with unilateral main bronchial stenosis. Clin Exp Otorhinolaryngol. 2015;8(2):161–6.CrossRef Ko Y, et al. Changes in the flow-volume curve according to the degree of stenosis in patients with unilateral main bronchial stenosis. Clin Exp Otorhinolaryngol. 2015;8(2):161–6.CrossRef
12.
go back to reference Grillo HC, Donahue DM. Postintubation tracheal stenosis. Chest Surg Clin N Am. 1996;6(4):725–31.PubMed Grillo HC, Donahue DM. Postintubation tracheal stenosis. Chest Surg Clin N Am. 1996;6(4):725–31.PubMed
13.
go back to reference Carretta A, et al. Preoperative assessment in patients with postintubation tracheal stenosis: rigid and flexible bronchoscopy versus spiral CT scan with multiplanar reconstructions. Surg Endosc. 2006;20(6):905–8.CrossRef Carretta A, et al. Preoperative assessment in patients with postintubation tracheal stenosis: rigid and flexible bronchoscopy versus spiral CT scan with multiplanar reconstructions. Surg Endosc. 2006;20(6):905–8.CrossRef
14.
go back to reference Weber AL. Radiologic evaluation of the trachea. Chest Surg Clin N Am. 1996;6(4):637–73.PubMed Weber AL. Radiologic evaluation of the trachea. Chest Surg Clin N Am. 1996;6(4):637–73.PubMed
15.
go back to reference Brichet A, et al. Multidisciplinary approach to management of postintubation tracheal stenoses. Eur Respir J. 1999;13(4):888–93.CrossRef Brichet A, et al. Multidisciplinary approach to management of postintubation tracheal stenoses. Eur Respir J. 1999;13(4):888–93.CrossRef
16.
go back to reference Ozkul Y, et al. Tracheal resection with primary anastomosis. J Craniofac Surg. 2015;26:1933–5.CrossRef Ozkul Y, et al. Tracheal resection with primary anastomosis. J Craniofac Surg. 2015;26:1933–5.CrossRef
17.
go back to reference Lovas JG, Lovas DA. Rapid relaxation–practical management of preoperative anxiety. J Can Dent Assoc. 2007;73(5):437–40.PubMed Lovas JG, Lovas DA. Rapid relaxation–practical management of preoperative anxiety. J Can Dent Assoc. 2007;73(5):437–40.PubMed
18.
go back to reference Agarwal A, et al. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia. 2005;60(10):978–81.CrossRef Agarwal A, et al. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia. 2005;60(10):978–81.CrossRef
19.
go back to reference Wilkey BJ, et al. Anesthesia for tracheobronchial surgery. Semin Cardiothorac Vasc Anesth. 2012;16(4):209–19.CrossRef Wilkey BJ, et al. Anesthesia for tracheobronchial surgery. Semin Cardiothorac Vasc Anesth. 2012;16(4):209–19.CrossRef
20.
go back to reference • Wiedemann K, Mannle C. Anesthesia and gas exchange in tracheal surgery. Thorac Surg Clin. 2014;24(1):13–25. This article provides an overview of a multitude of ways to maintain oxygenation and ventilation during a wide array of airway surgeries. It includes both the more common methods that we discuss as well as considerably less common approaches. • Wiedemann K, Mannle C. Anesthesia and gas exchange in tracheal surgery. Thorac Surg Clin. 2014;24(1):13–25. This article provides an overview of a multitude of ways to maintain oxygenation and ventilation during a wide array of airway surgeries. It includes both the more common methods that we discuss as well as considerably less common approaches.
21.
go back to reference Ramachandran SK, et al. Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration. J Clin Anesth. 2010;22(3):164–8.CrossRef Ramachandran SK, et al. Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration. J Clin Anesth. 2010;22(3):164–8.CrossRef
22.
go back to reference Geffin B, Bland J, Grillo HC. Anesthetic management of tracheal resection and reconstruction. Anesth Analg. 1969;48(5):884–90.CrossRef Geffin B, Bland J, Grillo HC. Anesthetic management of tracheal resection and reconstruction. Anesth Analg. 1969;48(5):884–90.CrossRef
23.
go back to reference Pinsonneault C, Fortier J, Donati F. Tracheal resection and reconstruction. Can J Anaesth. 1999;46(5 Pt 1):439–55.CrossRef Pinsonneault C, Fortier J, Donati F. Tracheal resection and reconstruction. Can J Anaesth. 1999;46(5 Pt 1):439–55.CrossRef
24.
go back to reference Sutterlin R, et al. Influence of tracheal obstruction on the efficacy of superimposed high-frequency jet ventilation and single-frequency jet ventilation. Anesthesiology. 2015;123:799–809.CrossRef Sutterlin R, et al. Influence of tracheal obstruction on the efficacy of superimposed high-frequency jet ventilation and single-frequency jet ventilation. Anesthesiology. 2015;123:799–809.CrossRef
25.
go back to reference Biro P. Jet ventilation for surgical interventions in the upper airway. Anesthesiol Clin. 2010;28(3):397–409.CrossRef Biro P. Jet ventilation for surgical interventions in the upper airway. Anesthesiol Clin. 2010;28(3):397–409.CrossRef
26.
go back to reference Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anesth. 2002;14(1):15–8.CrossRef Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anesth. 2002;14(1):15–8.CrossRef
27.
go back to reference Venkatesan T, Korula G. A comparative study between the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous lignocaine on coughing and hemodynamics during extubation in neurosurgical patients: a randomized controlled double-blind trial. J Neurosurg Anesthesiol. 2006;18(4):230–4.CrossRef Venkatesan T, Korula G. A comparative study between the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous lignocaine on coughing and hemodynamics during extubation in neurosurgical patients: a randomized controlled double-blind trial. J Neurosurg Anesthesiol. 2006;18(4):230–4.CrossRef
Metadata
Title
Breathing Through a Straw: Considerations for Tracheal Stenosis Surgery
Authors
Nathaniel J. Brown
Ferenc Puskas
Publication date
01-06-2016
Publisher
Springer US
Published in
Current Anesthesiology Reports / Issue 2/2016
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-016-0158-5

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