Tracheal stenosis (TS) is a debilitating disease promoted by pathologic narrowing of the trachea. The acute respiratory distress syndrome caused by COVID-19 has been demonstrated to trigger enhanced inflammatory response and to require prolonged invasive mechanical ventilation as well as high frequency of re-intubation or emergency intubation, thus increasing the rate and complexity of TS. The standard-of-care of COVID-19-related tracheal complications has yet to be established and this is a matter of concern. This review aims at collecting latest evidence on this disease, providing an exhaustive overview on its distinctive features and open issues, and investigating different diagnostic and therapeutic strategies to handle COVID-19-induced TS, focusing on endoscopic versus open surgical approach. The former encompasses bronchoscopic procedures: electrocautery or laser-assisted incisions, ballooning dilation, submucosal steroid injection, endoluminal stenting. The latter consists of tracheal resection with end-to-end anastomosis. As a rule, traditionally, the endoscopic management is restricted to short, low-grade, and simple TS, whereas the open techniques are employed in long, high-grade, and complex TS. However, the critical conditions or extreme comorbidities of several COVID-19 patients, as well as the marked inflammation in tracheal mucosa, have led some authors to apply endoscopic management also in complex TS, recording acceptable results. Although severe COVID-19 seems to be an issue of the past, its long-term complications are still unknown and considering the increased rate and complexity of TS in these patients, we strongly believe that it is worth to focus on it, attempting to find the best management strategy for COVID-19-related TS.
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http://dx.doi.org/10.3389/fsurg.2023.1118477 | DOI Listing |
JA Clin Rep
December 2024
Department of Anesthesiology, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori, 030-8553, Japan.
Background: Hypermagnesemia is a rare complication, leading to fatal cardiovascular and respiratory conditions. We present severe hypermagnesemia developed in a patient with a rectal stenosis after pretreatment with oral magnesium citrate for rectosigmoid surgery.
Case Presentation: A 78-year-old woman demonstrated consciousness disturbance, muscle weakness, and respiratory depression requiring tracheal intubation after preparation with oral magnesium for rectosigmoid surgery.
BMC Musculoskelet Disord
December 2024
Department of Orthopedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.
Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic non-inflammatory disorder characterized by enthesopathy and osteophyte formation. DISH can also cause several other symptoms. Limited range of motion (ROM) is the most common symptom; however, dysphagia and respiratory distress are clinically important symptoms.
View Article and Find Full Text PDFObjective: Analysis of risk factors for restenosis after intervention for tuberculous airway stenosis.
Methods: We retrospectively collected the clinical data of patients diagnosed with tuberculous airway stenosis in the Second Hospital of Lanzhou University and Lanzhou Pulmonary Hospital from January 2021 to June 2023. The patients were divided into the restenosis group and the non-restenosis group according to whether or not restenosis occurred in the airway within 1 year after the intervention, and the differences in the clinical data between the two groups were compared, and the variables with statistically significant differences in the univariate analysis were analyzed by multifactorial binary logistic regression.
J Indian Assoc Pediatr Surg
November 2024
Department of Pediatrics, K. S. Hegde Medical Academy, Mangalore, Karnataka, India.
Prolonged mechanical ventilation following cardiopulmonary and neurological events oftentimes necessitates a tracheostomy and tracheal granulation is one of its most common late complications. The literature recommends that large granulation be managed through surgical excision or endoluminal techniques. A 6-year-old boy presented with high-grade tracheal stenosis secondary to endotracheal cuff-related injury and prolonged tracheostomy.
View Article and Find Full Text PDFEur J Cardiothorac Surg
December 2024
Department of Thoracic Surgery, Sant'Andrea Hospital-Sapienza University, Rome, (Italy).
Objectives: Idiopathic subglottic stenosis(ISS) is an airway stricture between larynx and trachea, within 1 cm from the vocal cords. Resection-reconstruction presents technical issues because of the need to resect the anterior portion of the cricoid cartilage, but not the posterior plate beyond which the recurrent laryngeal nerves access the vocal cords. The main surgical challenge consists of the minute airway caliber short below the cords, ensuing after the resection.
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