Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-28T06:01:21.203Z Has data issue: false hasContentIssue false

Tracheal ring herniation following percutaneous dilatational tracheostomy and its resection under endoscopic control

Published online by Cambridge University Press:  29 June 2007

J. E. Osborne*
Affiliation:
Department of Otolaryngology, Glan Clwyd Hospital, Bodelwyddan, North Wales, UK.
E. Z. Osman
Affiliation:
Department of Otolaryngology, Glan Clwyd Hospital, Bodelwyddan, North Wales, UK.
P. Cuddihy
Affiliation:
Department of Otolaryngology, Glan Clwyd Hospital, Bodelwyddan, North Wales, UK.
M. Ranta
Affiliation:
Department of Otolaryngology, Glan Clwyd Hospital, Bodelwyddan, North Wales, UK.
*
Address for correspondence: Mr J. E. Osborne, Department of Otolaryngology, Glan Clwyd Hospital, Bodelwyddan LL18 5UJ.

Abstract

A 76-year-old patient had an elective percutaneous dilatational tracheostomy (PDT) under endoscopic control in the intensive care unit. Twelve days later when her general condition improved, two attempts at decannulation failed due to upper airway obstruction above the tracheostomy site.

Bronchoscopy showed herniation of the anterior tracheal wall above the tracheostomy tube occluding 80 per cent of the lumen. The herniated anterior segment was elevated and partially resected under endoscopic guidance. The patient made a full recovery and was decannulated on the first post-operative day. Pitfalls and possible complications of PDT are discussed.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bradley, P. J. (1997) Management of the obstructed airway and tracheostomy. In Scott-Brown's Otolaryngotogy. 6th Edition. (Kerr, A. G., Hibbert, J., eds.) Butterworth Heinemann, Oxford, pp 5/7/15/7/19.Google Scholar
Ciagla, P., Firsching, R., Syniec, C. (1985) Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest 87: 715719.CrossRefGoogle Scholar
Ciagla, P., Graniero, K. D. (1992) Percutaneous dilatational tracheostomy. Results and long-term follow-up. Chest 101: 464467.Google Scholar
Fischler, M. P., Kuhn, M., Cantieni, R., Frutiger, A. (1995) Late outcome of percutaneous dilatational tracheostomy in intensive care patients. Intensive Care Medicine 21: 475481.CrossRefGoogle ScholarPubMed
Frosh, A., Thomas, M. L., Weinbren, J., Djazaeri, B., Richards, A. (1997) Tracheal ring rupture and herniation during percutaneous dilatational tracheostomy identified by fibreoptic bronchoscopy. Revue de Laryngologie Otologie Rhinologie 118: 179180.Google Scholar
Hazard, P., Jones, C., Benitone, J. (1991) Comparative trial of standard operative tracheostomy with percutaneous tracheostomy. Critical Care Medicine 19: 10181023.Google Scholar
Law, R. C., Camey, A. S., Manara, A. R. (1997) Long-term outcome after percutaneous dilatational tracheostomy. Anaesthesia 52: 5156.Google Scholar
McFarlane, C., Denholm, S. W., Sudlow, C. L. M., Moralee, S. J., Grant, I. S., Lee, A. (1994) Laryngotracheal stenosis: a serious complication of percutaneous tracheostomy. Anaesthesia 49 3840.CrossRefGoogle ScholarPubMed
Marx, W. H., Ciagla, P., Graniero, K. D. (1996) Some important details in the technique of percutaneous dilatational tracheostomy via the modified Seldinger technique. Chest 110; 762766.Google Scholar
Powell, D. M., Price, P. D., Arick Forrest, L. (1998) Review of percutaneous tracheostomy. Laryngoscope 108: 170177.CrossRefGoogle ScholarPubMed
Van Heurn, L. W. E., Theunissen, P. H. M. H., Ramsay, G., Brink, P. R. G. (1996) Pathologic changes of the trachea after percutaneous dilatational tracheotomy. Chest 109: 14661469.Google Scholar
Wagmeister, L., Naunheim, K., Stack, B. C. Jr.(1999) An unusual complication from percutaneous bedside tracheostomy. International Online Journal of Otorhinolaryngology – Head and Neck Surgery 2: Issue 3.Google Scholar
Winkler, W. B., Karnik, R., Seelmann, O., Havlicek, J., Slany, J. (1994) Bedside percutaneous dilatational tracheostomy with endoscopic guidance: experience with 71 ICU patients. Intensive Care Medicine 20: 476479.CrossRefGoogle ScholarPubMed