Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak
This case is a patient with amyotrophic lateral sclerosis who was unable to be separated from mechanical ventilator support and required a tracheostomy. The patient underwent an initial open tracheostomy utilizing flexible fiberoptic tracheoscopy (FFT) in the operating room (OR). Subsequently, he de...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2015/379397 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841524691033915392 |
|---|---|
| author | Jian P. Azimi-Bolourian Issa A. Hanna George W. Williams |
| author_facet | Jian P. Azimi-Bolourian Issa A. Hanna George W. Williams |
| author_sort | Jian P. Azimi-Bolourian |
| collection | DOAJ |
| description | This case is a patient with amyotrophic lateral sclerosis who was unable to be separated from mechanical ventilator support and required a tracheostomy. The patient underwent an initial open tracheostomy utilizing flexible fiberoptic tracheoscopy (FFT) in the operating room (OR). Subsequently, he developed recurrent leaks in the tracheal tube cuff requiring multiple trips back to the operating room. The recurrent cuff leak occurred following each tube placement until the etiology of the leak was discovered during the fourth procedure. In the fourth procedure, the wound was explored more extensively, and it was found that there was a sharp, calcified, aberrant fragment of a tracheal cartilage ring protruding into the tracheal lumen, which was damaging the cuff of each tube. This fragment was not visible by multiple FFTs, nor was it visible in the wound by the surgeons until wider exploration of the wound occurred. The cartilage fragment was ultimately excised and the patient had no further cuff leaks. Aberrant tracheal cartilage should be on the differential diagnosis for cuff leaks subsequent to surgical tracheostomy (ST) or percutaneous dilatational tracheostomy (PDT). |
| format | Article |
| id | doaj-art-a04f4cdb835e43628c3880b78f8ad7d5 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-a04f4cdb835e43628c3880b78f8ad7d52025-02-03T05:47:36ZengWileyCase Reports in Anesthesiology2090-63822090-63902015-01-01201510.1155/2015/379397379397Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff LeakJian P. Azimi-Bolourian0Issa A. Hanna1George W. Williams2Department of Anesthesiology, The University of Texas Medical School at Houston, Houston, TX 77030, USADepartment of Oral Maxillofacial Surgery, The University of Texas School of Dentistry at Houston, Houston, TX 77030, USADepartments of Anesthesiology and Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USAThis case is a patient with amyotrophic lateral sclerosis who was unable to be separated from mechanical ventilator support and required a tracheostomy. The patient underwent an initial open tracheostomy utilizing flexible fiberoptic tracheoscopy (FFT) in the operating room (OR). Subsequently, he developed recurrent leaks in the tracheal tube cuff requiring multiple trips back to the operating room. The recurrent cuff leak occurred following each tube placement until the etiology of the leak was discovered during the fourth procedure. In the fourth procedure, the wound was explored more extensively, and it was found that there was a sharp, calcified, aberrant fragment of a tracheal cartilage ring protruding into the tracheal lumen, which was damaging the cuff of each tube. This fragment was not visible by multiple FFTs, nor was it visible in the wound by the surgeons until wider exploration of the wound occurred. The cartilage fragment was ultimately excised and the patient had no further cuff leaks. Aberrant tracheal cartilage should be on the differential diagnosis for cuff leaks subsequent to surgical tracheostomy (ST) or percutaneous dilatational tracheostomy (PDT).http://dx.doi.org/10.1155/2015/379397 |
| spellingShingle | Jian P. Azimi-Bolourian Issa A. Hanna George W. Williams Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak Case Reports in Anesthesiology |
| title | Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak |
| title_full | Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak |
| title_fullStr | Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak |
| title_full_unstemmed | Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak |
| title_short | Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak |
| title_sort | case report of multiple tracheostomy revisions due to persistent recurrent cuff leak |
| url | http://dx.doi.org/10.1155/2015/379397 |
| work_keys_str_mv | AT jianpazimibolourian casereportofmultipletracheostomyrevisionsduetopersistentrecurrentcuffleak AT issaahanna casereportofmultipletracheostomyrevisionsduetopersistentrecurrentcuffleak AT georgewwilliams casereportofmultipletracheostomyrevisionsduetopersistentrecurrentcuffleak |