Imanishi Naoko
   Department   University Hospital  General Thoracic Surgery, Clinical Departments
   Position  
Language English
Title V-009 A CASE OF MEDIASTINAL TRACHEOSTOMY FOR TRACHEOSTENOSIS AFTER TRACHEOSTOMY WITH TRACHEOMALACIA BY MUCOPOLYSACCHARIDOSIS
Conference 25th European Conference on General Thoracic Surgery
Conference Type International society and overseas society
Presentation Type Poster notice
Lecture Type Panelist at Symposium/Workshop (Applied)
Publisher and common publisherYasuhiro Chikaishi, M. Takenaka, K. Kuroda, N. Imanishi, F. Tanaka
Date 2017/05/29
Venue
(city and name of the country)
Congress Innsbruck, Innsbruck, Austria
Summary Objectives: Treatment of tracheostenosis for granulation after tracheostomy in congenital diseases is often difficult for several season. Mucopolysaccharidosis are a lysosomal storage diseases that are complicated by severe obstruction of the upper airways, tracheobronchial malacia, and/or stenosis of the lower airways. Video description: We present a case of a 16 year old boy. He had been followed up for mucopolysaccharidosis type II since postnatal period. Five years ago, when he was 11 years old, tracheostomy was performed for laryngeal stenosis by primary disease. One week ago, he had an emergency transportation to our hospital for major dyspnea. He was diagnosed with tracheostenosis due to granulation after tracheostomy, so he was admitted under ventilation. Difficulties were encoutered in orientation of airway for macroglossia, swelling of tonsil and tracheomalacia from mucopolysaccharidosis. For airway management, mediastinal tracheostomy was performed with percutaneous cardio pulmonary support (PCPS). The trachea was then exposed at head site. Trachea was resected by the minimum required length. In order to keep the blood flow, skin incision of mediastinal trachea hole had been cut sharp without electorotome. Mediastinal tracheostomy was performed with inlay graft of thymus between innominate and trachea. The postoperative course was uneventful, and the patient was weaned from ventilator on postoperative day 19. He was discharged on postoperative day 45. Airway patency was maintained up to one year after surgery. Conclusions: Mediastinal tracheostomy was useful for treatment of tracheostenosis for granulation after tracheostomy to laryngeal stenosis by mucopolysaccharidosis. We presented this case in a video image file.