Abstract
Post-intubation stenosis are the most frequent indications for tracheal resection and reconstructions. They are mostly caused postintubation inflated cuff and after distal tracheostomy. 16- year-old female was admitted to thoracic surgery department, General hospital Vienna with the diagnosis of an impossible weaning with a tracheostomy in place. The pre-operative bronchoscopy and MSCT of the neck evaluation revealed a total occlusion of the trachea below the cricoid arch and reaching distally to the level of the tracheostomy (total length approx. 3cm) by means of an acquired tracheostomy-associated tracheal stenosis (Myer-Cotton IV°). The distal trachea was unaffected. Thus, the indication for a surgical repair was set. Tracheal resection through a cervical incision was performed. The pre-existing tracheostomy as well as the stenotic segment was resected (resection length approx. 3.5cm) and a cricotracheal end-to-end anastomosis was performed. Subglottic resection of the trachea is rare, if conducted a good selection of patients performed precise surgical procedures with the support of anesthesia is considered by some to be the procedure of choice for the treatment severe (>70% luminal obstruction).
