Assessment

It is very important that the larynx be functioning adequately before tracheal reconstruction surgery is attempted. Tracheal stenosis resection and primary reanastomosis can be accomplished without a tracheo-stomy in a setting of an adequate laryngeal airway. Such complex tracheal surgery can only be successful in the setting of a patent larynx. Adequate evaluation of the larynx for stenosis and or paralysis and correction of any problem is essential if subsequent tracheal surgery is to be...

Rheumatoid Nodule

A case of tracheal rheumatoid nodules in a 45-year-old Chinese man has been reported.17 The patient had suffered rheumatoid arthritis for 7 years, with articular manifestations and deformities. Subcutaneous rheumatoid nodules had been present over his elbows and hands. Endoscopy showed four smooth, whitish nodules, each 3 to 5 mm in diameter. Further specification was not possible on endoscopic findings. Histologic examination showed foci of necrobiosis and vascular fibrinoid necrosis in the...

Tracheostomy

Other than being a surgical technique, tracheostomy has many aspects that merit discussion hence, I thought it best to consider these in a section of this book which is otherwise devoted to diseases of the trachea. Included elsewhere are historical notes on tracheostomy, surgical technique (see Chapter 22, Tracheostomy, Minitracheostomy, and Closure of Persistent Stoma), tracheostomy devices (see Chapter 38, Tracheal Appliances and Chapter 39, Tracheal T Tubes), and stents (see Chapter 40,...

What Is Thickening Bronchial

Fibrosing mediastinitis is a complication of granulomatous mediastinitis, resulting from infection from Histoplasma capsulatum and, less commonly, Mycobacterium tuberculosis. It has also been associated with the use of methysergide. Fibrosing mediastinitis is characterized by a proliferation of fibrous tissue in the mediastinum, which surrounds, invades, and sometimes obliterates normal structures, including the trachea and bronchi, esophagus, vena cava, pulmonary veins and arteries, and...

Bilateral Vocal Cord Paralysis

In patients with bilateral vocal cord paralysis, the classic treatment has been an arytenoidectomy, either performed endoscopically or from the laryngofissure approach.8,9 If a patient has arytenoid fixation, either traumatic or from rheumatoid arthritis, this is still the procedure of choice. The arytenoid is removed and the posterior cord is sutured laterally to the thyroid cartilage. If the arytenoids are mobile, a simpler technique is to endoscopically lateralize the vocal cord.10-12 A no....

Inflammatory or Infiltrative Lesions

Relapsing Polychondritis Radiology

A group of unrelated lesions are discussed here. Their only common feature is an alteration or infiltration of tracheal and bronchial walls by non-neoplastic processes that are clinically well characterized, but are of unknown cause. Idiopathic stenosis could well be included, in that it largely shows collagenous deposition in the larynx and trachea. Relapsing polychondritis remains a disease of unknown origin, characterized principally by inflammatory degeneration of articular and...

References

Smith LS, Schillaci RF, Sarlin RF. Endobronchial tuber- 2. Macchiarini P, Delamare N, Beuzeboc P, et al. Tracheo- culosis. Serial fiberoptic bronchoscopy and natural esophageal fistula caused by mycobacterial tuberculosis history. Chest 1987 91 644-7. adenopathy. Ann Thorac Surg 1993 55 1561-3. 3. Newton JR, Grillo HC, Mathisen DJ. Main bronchial sleeve resection with pulmonary conservation. Ann Thorac Surg 1991 52 1272-80. 4. Mitchell JD, Mathisen DJ, Donahue DM, et al. Clinical experience...