0
Cardiothoracic Surgery |

Management of Upper Airway Stenosis After Inhalation Injury

Fernando Abdala*, MD; Oscar Abdala, MD
Author and Funding Information

Sanatorio de Los Arcos, Buenos Aires, Argentina


Chest. 2012;142(4_MeetingAbstracts):52A. doi:10.1378/chest.1388899
Text Size: A A A
Published online

Abstract

SESSION TYPE: Thoracic Surgery Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: The pathogenesis of upper airway stenosis (UAS) in burned patients combines the effects of inhaled gases, heat and usually intubation. The persistence of inflammatory signs, length and complexity of these lesions seems to be greater than other benign stenosis. The aim of this study was to describe the presentation,treatment and results of a group of patients evaluated for UAS after inhalation injury.

METHODS: All patients with UAS after inhalation injury evaluated by the authors from January 2006 to January 2011 were included. All the surgical centers were approved by national or provincial health department to perform this kind of procedures. The demographics,lesion description, initial and definitive management and surgical results were prospectively recorded.

RESULTS: A total of 10 patients were included (males 5, females 5). Mean age was 31 years (18 to 41 years). Mean follow-up: 41 months (12 to 72 months).Seven patients had combined laryngeal and tracheal lesions. There were 8 Laryngeal (1 unilateral vocal cord paralysis, 1 aritenoid fixation and 6 subglottic stenosis), 8 proximal and mid tracheal and 1 lower tracheal lesions. Phonation was impaired in 5 patients. Initial management was tracheostomy in 4 patients, tracheal stent placement in 3 ,surgical resection in 2 and rigid bronchoscopic dilation in 1. Definitive laryngotracheal resections were performed in 9 patients. The other one had a permanent tracheal stent. Time from inhalation injury to surgery was 12,6 months (6 to 24 months). Mean Length of resection was 4 cm (3 to 6 cm). One patient presented an anastomotic granuloma (resolved with laser resection) and other a restenosis (treated with stent placement). Both of them were operated before one year of the airway injury. There were not other complications nor deaths.

CONCLUSIONS: Most of the UAS observed were extense and almost all involved the larynx and trachea (7 cases). The results of surgical treatment were excellent when postponed until endoscopic signs of inflammation succeeded and large tracheal resections could be performed without significant complications. All the patients with phonation impairment recovered vocal communication.

CLINICAL IMPLICATIONS: Laryngotracheal resection should be the main therapeutic option in the management of this complex group of patient. Although it is important to have other tools that allow the patient to be safe when waiting for the perfect surgical spot.

DISCLOSURE: The following authors have nothing to disclose: Fernando Abdala, Oscar Abdala

No Product/Research Disclosure Information

Sanatorio de Los Arcos, Buenos Aires, Argentina

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543