Altun Demet, Sivrikoz Nükhet, Çamcı Emre
Department of Anaesthesiology and Reanimation, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2015 Oct;43(5):363-6. doi: 10.5152/TJAR.2015.98360. Epub 2015 Aug 21.
Wegener granulomatosis (WG) is a multisystemic disorder characterised by granulomatous inflammation of the respiratory system. The growing of proliferative tissue towards the larynx and trachea may cause airway obstruction on account of subglottic stenosis. In this situation, the surgical goal is to eliminate the airway obstruction by providing natural airway anatomy. While mild lesions do not require surgical intervention, in fixed lesions, surgical intervention is required, such as tracheostomy, laser resection and dilatation. In tracheostomised patients, granuloma formation surrounding the tracheostomy cannula may occur in the trachea. Inflammation and newly formed granulation tissue result in severe stenosis in the airways. During surgical treatment of such patients, airway management is important. In this case report, we will discuss gas exchange and airway management with jet ventilation (JV) during excision of the granulation tissue with endolaryngeal laser surgery, leading to subglottic stenosis in tracheostomised patients in WG.
韦格纳肉芽肿病（WG）是一种多系统疾病，其特征为呼吸系统的肉芽肿性炎症。增生组织向喉和气管生长可能因声门下狭窄导致气道阻塞。在这种情况下，手术目标是通过恢复自然气道解剖结构来消除气道阻塞。轻度病变无需手术干预，而对于固定性病变，则需要进行手术干预，如气管切开术、激光切除和扩张术。在接受气管切开术的患者中，气管切开套管周围可能会在气管内形成肉芽肿。炎症和新形成的肉芽组织会导致气道严重狭窄。在此类患者的手术治疗过程中，气道管理至关重要。在本病例报告中，我们将讨论在对韦格纳肉芽肿病气管切开患者进行喉内激光手术切除肉芽组织导致声门下狭窄时，采用喷射通气（JV）进行气体交换和气道管理的情况。
