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Tubeless tracheal resection and reconstruction for management of benign stenosis
Author(s) -
Caronia Francesco Paolo,
Loizzi Domenico,
Nicolosi Tommaso,
Castorina Sergio,
Fiorelli Alfonso
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24942
Subject(s) - medicine , remifentanil , lidocaine , tracheal stenosis , anesthesia , sedation , surgery , respiratory distress , stridor , stenosis , ventilation (architecture) , local anesthesia , resection , dexmedetomidine , radiology , propofol , airway , mechanical engineering , engineering
Background We reported a tubeless tracheal resection and reconstruction for the management of benign posttracheostomy tracheal stenosis. Methods A 34‐year‐old man with stridor, severe respiratory distress, and recurrent pneumonia was referred to our attention for treatment of benign posttracheostomy tracheal stenosis. As he refused general anesthesia, the procedure was performed while he was under local anesthesia and spontaneous ventilation. Results Sedation was started with infusion of dexmedetomidine 0.7 mg/kg/min and of remifentanil 0.5 mg/kg/h; also, 40%‐50% oxygen was delivered using a laryngeal mask at a rate of 3.5 mL/min. An additional dose of 2% lidocaine was injected into the surgical site during the operation to achieve an adequate level of anesthesia. A standard resection and reconstruction of trachea was carried out and no recurrence was found in the follow‐up of 41 months. Conclusion Tubeless tracheal surgery seems to be a feasible and safe procedure. Larger prospective series should validate our results.