The trachea:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | Chest surgery clinics of North America
6,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XI S., S. 627 - 913 Ill., graph. Darst. |
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| 490 | 1 | |a Chest surgery clinics of North America |v 6,4 | |
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Datensatz im Suchindex
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| adam_text | THE TRACHEA
CONTENTS
Preface xiii
Douglas J. Mathisen
Surgical Anatomy of the Trachea 627
Mark S. Allen
A clear understanding of tracheal anatomy is a fundamental
building block for surgical procedures. Surprisingly, information
about the surgical anatomy of the trachea is scant. This article
describes the anatomy of the trachea and highlights how these
anatomic facts affect surgical procedures performed on the tra¬
chea.
Radiologic Evaluation of the Trachea 637
Alfred L. Weber
Tracheal lesions are categorized into stenoses of various etiolo¬
gies, inflammatory lesions, benign and malignant tumors, vascu¬
lar anomalies affecting the trachea, and miscellaneous conditions
including amyloid, polychondritis, and tracheobronchopathia
osteochondroplastica. For evaluation of the extent and character¬
ization of these lesions, different radiologic modalities can be
utilized, which include fluoroscopy with barium swallow, con¬
ventional films, linear tomography, computerized tomography
scan, and magnetic resonance imaging, including magnetic reso¬
nance angiography. The radiologic indications and findings are
described in this article.
Tracheal Release Maneuvers 675
Richard F. Heitmiller
Tracheal release procedures are specialized surgical techniques
designed to permit low tension end to end primary reconstruc
| CHEST SURGERY CLINICS OF NORTH AMERICA
VOLUME 6 • NUMBER 4 • NOVEMBER 1996 vii
tion after tracheal sleeve resection. Therefore, an understanding
of the principles and techniques of these tracheal release maneu¬
vers is essential in order to perform tracheal surgery safely. The
release procedures include dissection of the pretracheal plane,
cervical flexion, and laryngeal and hilar release. Dissection of the
pretracheal plane and cervical flexion are the most commonly
employed techniques.
Technique of Management of Subglottic Stenosis 683
F. Griffith Pearson
There have been innumerable approaches to the management
of subglottic stenosis, which bear testimony to the difficulty in
obtaining predictably satisfactory results. Management includes
techniques of endoscopic dilation, laser resection, laryngofissure
and stenting, and an ingenious array of plastic reconstructions
with or without postoperative stenting. On occasion, permanent
intubation with a conventional distal tracheotomy or a silicone
rubber T tube may be used.
Pediatric Tracheal Problems 693
Hermes C. Grillo
Awareness of the special problems of airway repair in children
and precise application of principles of tracheal and laryngotra
cheal surgery are necessary for success in treating acquired pedi¬
atric airway lesions. Long segment congenital lesions require
special techniques, which are still evolving.
Anterior Mediastinal Tracheostomy 701
Mark B. Orringer
Anterior mediastinal tracheostomy (AMT) facilitates resection of
stomal recurrences after laryngectomy for carcinoma and tumors
involving the cervicothoracic trachea and esophagus. The need
for a concomitant laryngopharyngoesophagectomy and restora¬
tion of alimentary continuity with either a pharyngogastric or
pharyngocolic anastomosis is common. Although erosion of the
innominate artery has been reported as a frequent complication
of AMT, transposition of the remaining tracheal stump beneath
and to the right of the innominate artery eliminates tension on
the vessel and the risk of erosion. Anterior mediastinal tracheos¬
tomy is a valuable adjunct in the treatment of selected patients
with malignancies of the cervicothoracic trachea and esophagus,
and with attention to operative detail, innominate artery erosion
rarely if ever complicates the operation. Prophylactic division of
the innominate artery at the time of AMT is unnecessary.
Postintubation Tracheal Stenosis 725
Hermes C. Grillo and Dean M. Donahue
Resection and reconstruction are the treatments of choice for
postintubation tracheal stenosis, attested to by 94% good or satis
viii CONTENTS
factory results in over 500 patients. Accurate diagnosis, appro¬
priate patient selection, and experienced and precise surgical care
are important in these treatments.
Laryngotracheal Trauma 733
Franchise P. Chagnon and David S. Mulder
Isolated trauma to the airway is infrequent yet potentially life
threatening. The larynx and cervical trachea are vulnerable to
external forces, whether penetrating or blunt, as well as internal
injuries from endotracheal or nasogastric intubation and to ther¬
mal burns from the inhalation of fumes or the ingestion of caustic
substances.
Tracheostomy 749
Douglas E. Wood
Tracheostomy is a common procedure used by a wide variety of
surgeons. Complications after tracheostomy have been used as a
rationale for prolonging a translaryngeal intubation. Understand¬
ing the pathogenesis of tracheostomy complications combined
with meticulous surgical and perioperative management avoids
the majority of complications. The remaining complications are
readily managed and should not provide a rationale for denying
intubated patients the benefits of tracheostomy.
Management of Malignant Esophagorespiratory Fistula 765
Michael Burt
For patients with malignant esophagorespiratory fistula, four im¬
portant points need to be stressed: (1) once the diagnosis is made,
treatment should be instituted immediately; (2) all treatment is
palliative and directed at stopping soilage of the respiratory tract;
(3) the type of therapy is dictated by the performance status of
the patient at presentation; and (4) esophageal bypass offers the
best palliation for those able to tolerate the procedure.
Surgical Management of Thyroid Cancer Invading
the Trachea 777
Piero Zannini and Giulio Melloni
Airway invasion by thyroid carcinoma leads to death in a large
number of cases as a result of suffocation due to bleeding or
airway obstruction. A favorable prognosis may be obtained, how¬
ever, with proper treatment of tracheal invasion. The standardiza¬
tion of reliable techniques for tracheal resection and reconstruc¬
tion has made surgery a reasonable therapeutic approach to
neoplasms invading the trachea by contiguity or continuity. Re¬
section and reconstruction of the infiltrated airway afford excel¬
lent long term palliation for patients with invasive thyroid dis
CONTENTS ix
ease and could offer a cure if treatment is initiated at an early
stage of disease.
Techniques of Management of Subglottic Stenoses
With Glottic and Supraglottic Problems 791
Louis Couraud, Jaques B. Jougon, and M. Ballester
Glottic problems complicating a subjacent tracheal or subglottic
stenosis may result from various causes, such as glottic closure
due to fixation or paralysis of vocal cords, fibrous stenosing scars
of the glottis, or instability of arytenoid cartilages. Resecting scar
tissues, molding the closed glottis, and stenting a patent laryngeal
lumen until consolidation are the basic means which, when asso¬
ciated in selected indications, allow recovery of respiration and
speech through the normal routes.
Management of Idiopathic Tracheal Stenosis 811
Hermes C. Grillo
Idiopathic laryngotracheal stenosis usually occurs in women, pro¬
duces stenosis of 1 to 3 cm, is densely collagenous, and is unac¬
companied by systemic disease. It may be successfully managed
by one stage resection and reconstruction, most often including a
portion of the lower larynx.
Management of Acquired Tracheoesophageal Fistula 819
Philippe Dartevelle and Paolo Macchiarini
Acquired, nonmalignant tracheoesophageal fistulae usually result
from erosion of the tracheal and esophageal walls by endotracheal
or tracheostomy tube cuffs, especially when a rigid nasogastric
tube is in place. This has become an infrequent occurrence with
the use of high volume, low pressure cuffs, but it still represents
a life threatening condition. Spontaneous recovery is exceptional.
Most are diagnosed while patients still are mechanically venti¬
lated and, due to the negative effects of positive pressure ventila¬
tion on tracheal suture lines, repair should be delayed until pa¬
tients are weaned. After the patient is weaned from the ventilator,
a one staged anterior approach including esophageal closure, seg
mental tracheal resection, and primary reconstruction definitely
corrects the fistula and removes concurrent tracheal disease and
should be preferred to simple division and closure of the fistula.
Surgical Management of Congenital Tracheal Stenosis 837
John W. Brown, Ko Bando, Kyung Sun, and
Mark W. Turrentine
Long segment tracheal stenosis in infants and children is difficult
to manage and can be life threatening. Patients frequently have
associated cardiac, other respiratory, or gastrointestinal anomalies
that may confuse the diagnosis at initial presentation. The rarity
of congenital tracheal stenosis has not allowed sufficient experi¬
ence for the development of standard treatment protocol. Several
surgical techniques have been described but have varying results.
This article reviews the diagnosis and different surgical options
for congenital tracheal stenosis and their outcomes.
Complications of Tracheal Surgery 853
Douglas J. Mathisen
Complications of tracheal surgery are best managed by avoiding
them. This entails proper patient selection through evaluation;
careful coordination between anesthesia, otolaryngology, and tho¬
racic surgery; meticulous attention to the technical details of
operation; and postoperative care. There must be a firm under¬
standing of airway management in the postoperative period rang¬
ing from edema, anastomotic granulations, fistula, separation, or
recurrent stenosis. Successful management can be accomplished
with preservation of the airway.
Management of Tracheoinnominate Artery Fistula 865
Cameron D. Wright
Tracheoinnominate fistula is a rare and often fatal complication
after tracheostomy, tracheal resection, or mediastinal tracheos
tomy. Bronchoscopy is the diagnostic procedure of choice. Bed¬
side control of hemorrhage by cuff overinflation or digital arterial
compression may be lifesaving. Prompt operative division of the
innominate artery should be performed. Neurologic complica¬
tions are rare.
Tracheal Tumors 875
Douglas J. Mathisen
Tumors of the airway can be classified into malignant (squamous
and adenoidcystic) and low grade or benign neoplasms. The most
common tumors are squamous cancer and adenoidcystic, oc¬
curring in about equal numbers. Pre and intraoperative evalua¬
tions are mandatory, along with strict attention to technical de¬
tails and postoperative care. Both squamous cancers and
adenoidcystic cancers should be treated with postoperative irradi¬
ation. Successfully removed benign tumors do not require addi¬
tional therapy and are almost always cured by resection and
reconstruction.
QQQ
Cumulative Index 1996
Inside back cover
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| spelling | The trachea Douglas J. Mathisen, guest ed. Philadelphia [u.a.] Saunders 1996 XI S., S. 627 - 913 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Chest surgery clinics of North America 6,4 Trachée Trachea Luftröhrenkrankheit (DE-588)4260435-7 gnd rswk-swf Chirurgie (DE-588)4009987-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Luftröhrenkrankheit (DE-588)4260435-7 s Chirurgie (DE-588)4009987-8 s DE-604 Mathisen, Douglas J. Sonstige oth Chest surgery clinics of North America 6,4 (DE-604)BV005455558 6,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007467038&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | The trachea Chest surgery clinics of North America Trachée Trachea Luftröhrenkrankheit (DE-588)4260435-7 gnd Chirurgie (DE-588)4009987-8 gnd |
| subject_GND | (DE-588)4260435-7 (DE-588)4009987-8 (DE-588)4143413-4 |
| title | The trachea |
| title_auth | The trachea |
| title_exact_search | The trachea |
| title_full | The trachea Douglas J. Mathisen, guest ed. |
| title_fullStr | The trachea Douglas J. Mathisen, guest ed. |
| title_full_unstemmed | The trachea Douglas J. Mathisen, guest ed. |
| title_short | The trachea |
| title_sort | the trachea |
| topic | Trachée Trachea Luftröhrenkrankheit (DE-588)4260435-7 gnd Chirurgie (DE-588)4009987-8 gnd |
| topic_facet | Trachée Trachea Luftröhrenkrankheit Chirurgie Aufsatzsammlung |
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