Vakili Ojarood Mohammad, Samady Khanghah Ali
Department of Thoracic Surgery.
Department of Surgery, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
Ann Med Surg (Lond). 2023 Jul 24;85(9):4547-4552. doi: 10.1097/MS9.0000000000000379. eCollection 2023 Sep.
Tracheostomy has been done since ancient Greece, but in today's modern format, it has been accepted for over one and a half centuries. Improvements in medical care and treatments have survived disabled patients who died in the past decades. Among these, tracheostomy tube (TT) segment aspiration was as rare as less than 100 cases have already been documented. We reported a case of aspirated metal TT to the right main bronchus from a 12-year-old teenage girl and then reviewed the available literature.
The patient suffered from subglottic stenosis affected after adenotonsillectomy remained for 6 years. She was referred to the emergency department for acute respiratory distress and cyanosis. Immediately underwent rigid bronchoscopy, and on the way to the operating room, she was oxygenated from the tracheal orifice. The detached part was successfully removed.
The common tracheostomy indications in children involve congenital or acquired airway stenosis, some conditions needing long-term ventilation, bilateral vocal fold insufficiency, and infectious compromise of the upper airway. Metal TTs for long-lasting are preferred to synthetic ones. Nevertheless, it has some potential complications.
Careful inspecting, especially metallic TTs, after every disinfection and regular follow-up by the surgeon, is highly recommended to prevent potential casualties.
气管切开术自古希腊时期就已施行,但现代形式的气管切开术已被接受超过一个半世纪。医疗护理和治疗的进步使过去几十年中会死亡的残疾患者存活下来。其中,气管切开套管(TT)片段误吸极为罕见,文献记载的病例不足100例。我们报告了一例12岁少女的金属气管切开套管误吸至右主支气管的病例,并对现有文献进行了回顾。
该患者因腺样体扁桃体切除术后声门下狭窄持续6年。她因急性呼吸窘迫和发绀被转诊至急诊科。立即接受了硬质支气管镜检查,在前往手术室的途中,通过气管造口进行了给氧。分离的部分被成功取出。
儿童气管切开术的常见适应证包括先天性或后天性气道狭窄、一些需要长期通气的情况、双侧声带功能不全以及上呼吸道感染。长期使用的金属气管切开套管比合成套管更受青睐。然而,它有一些潜在并发症。
强烈建议外科医生在每次消毒后仔细检查,尤其是金属气管切开套管,并定期进行随访,以防止潜在的不良后果。