Khaja Sobia F, Fletcher Aaron M, Hoffman Henry T
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Ann Otol Rhinol Laryngol. 2011 Sep;120(9):622-6. doi: 10.1177/000348941112000912.
Tracheocutaneous fistulas may persist after tracheostomy. Suture closure of the fistula may result in complications, including infection, wound dehiscence, and pneumomediastinum. We present a simplified and relatively safe technique to close persistent fistulas that may be performed under local anesthesia. A retrospective chart review was performed on 13 patients who were successfully treated, including 1 with incomplete closure that was successfully addressed by additional procedures. Our review included analysis of reported risk factors for persistence of tracheocutaneous fistulas: previous irradiation of the neck, an extended duration of cannulation, previous tracheostomies, obesity, and use of a Bjork flap or 4-flap epithelial-lined tracheostomy. All 13 patients in the study were found to have at least 1 of these risk factors.
气管切开术后气管皮肤瘘可能持续存在。瘘管的缝合关闭可能导致并发症，包括感染、伤口裂开和气纵隔。我们提出一种简化且相对安全的技术来关闭可能在局部麻醉下进行的持续性瘘管。对13例成功治疗的患者进行了回顾性病历审查，其中1例闭合不完全，通过额外的手术成功解决。我们的审查包括对已报道的气管皮肤瘘持续存在的危险因素的分析：先前颈部放疗、插管时间延长、先前的气管切开术、肥胖以及使用比约克皮瓣或四瓣上皮内衬气管切开术。研究中的所有13例患者均被发现至少有这些危险因素中的一项。
