Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1971 Nov;26(6):696–703. doi: 10.1136/thx.26.6.696

Radiological evaluation of post-tracheostomy lesions

Alexander S Macmillan 1,2,3, A Everette James Jr 1,2,3, Frederick P Stitik 1,2,3, Hermes C Grillo 1,2,3
PMCID: PMC472384  PMID: 5144647

Abstract

Post-tracheostomy lesions are becoming more commonplace and surgical techniques for definitive repair of these abnormalities are being developed. These lesions, in general, occur at two sites, the proximal lesions at the tracheostomy incision and the distal lesions 1·5 to 2·5 cm inferior in the area of the tracheostomy balloon cuff. Granuloma formation, stenosis, tracheomalacia, and perforation of the tracheal wall have been encountered in our experience. Clinical symptoms depend upon the type and location of the lesion as well as on the patient's awareness and physical activity. Radiological evaluation offers an accurate method to depict the anatomical and physiological alterations. This radiological assessment should begin with routine postero-anterior and lateral chest radiographs followed by fluoroscopy. Laminograms and special oblique views are often helpful. Contrast tracheograms using powdered tantalum allow good mucosal detail as well as excellent delineation of structural and physiological abnormalities.

Full text

PDF
696

Images in this article

698Image
on p.698
698Image
on p.698
699Image
on p.699
699Image
on p.699
700Image
on p.700
700Image
on p.700
700Image
on p.700
701Image
on p.701
701Image
on p.701
702Image
on p.702

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ATKINS J. P. TRACHEAL REACTIONS FOLLOWING THE USE OF CUFFED TRACHEOTOMY TUBES. Ann Otol Rhinol Laryngol. 1964 Dec;73:1124–1129. doi: 10.1177/000348946407300423. [DOI] [PubMed] [Google Scholar]
  2. Cooper J. D., Grillo H. C. The evolution of tracheal injury due to ventilatory assistance through cuffed tubes: a pathologic study. Ann Surg. 1969 Mar;169(3):334–348. doi: 10.1097/00000658-196903000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Deverall P. B. Tracheal stricture following tracheostomy. Thorax. 1967 Nov;22(6):572–576. doi: 10.1136/thx.22.6.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Flavell G. Resection of Tracheal Stricture following Tracheotomy, with Primary Anastomosis. Proc R Soc Med. 1959 Feb;52(2):143–145. doi: 10.1177/003591575905200214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Flege J. B., Jr Tracheoesophageal fistula caused by cuffed tracheostomy tube. Ann Surg. 1967 Jul;166(1):153–156. doi: 10.1097/00000658-196707000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fraser K., Bell P. R. Distal tracheal stenosis following tracheostomy. Br J Surg. 1967 Apr;54(4):302–303. doi: 10.1002/bjs.1800540412. [DOI] [PubMed] [Google Scholar]
  7. GLAS W. W., KING O. J., Jr, LUI A. Complications of tracheostomy. Arch Surg. 1962 Jul;85:56–63. doi: 10.1001/archsurg.1962.01310010060008. [DOI] [PubMed] [Google Scholar]
  8. Gibson P. Aetiology and repair of tracheal stenosis following tracheostomy and intermittent positive pressure respiration. Thorax. 1967 Jan;22(1):1–6. doi: 10.1136/thx.22.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Grillo H. C. The management of tracheal stenosis following assisted respiration. J Thorac Cardiovasc Surg. 1969 Jan;57(1):52–71. [PubMed] [Google Scholar]
  10. Hinchcliffe W. A., Zamel N., Fishman N. H., Dedo H. H., Greenspan R. H., Nadel J. Roentgenographic study of the human trachea with powdered tantalum. Radiology. 1970 Nov;97(2):327–330. doi: 10.1148/97.2.327. [DOI] [PubMed] [Google Scholar]
  11. James A. E., Jr, Macmillan A. S., Jr, Eaton S. B., Grillo H. C. Roentgenology of tracheal stenosis resulting from cuffed tracheostomy tubes. Am J Roentgenol Radium Ther Nucl Med. 1970 Jul;109(3):455–466. doi: 10.2214/ajr.109.3.455. [DOI] [PubMed] [Google Scholar]
  12. James A. E., MacMillan A. S., Jr, Eaton S. B., Janower M. L., Grillo H. C. Radiological considerations of granuloma and stenosis at the site of tracheostomy. Radiology. 1970 Sep;96(3):513–520. doi: 10.1148/96.3.513. [DOI] [PubMed] [Google Scholar]
  13. Johnston J. B., Wright J. S., Hercus V. Tracheal stenosis following tracheostomy. A conservative approach to treatment. J Thorac Cardiovasc Surg. 1967 Feb;53(2):206–217. [PubMed] [Google Scholar]
  14. LU A. T., TAMURA Y., KOOBS D. H. The pathology of laryngotracheal complications. Lesions of the larynx and trachea after intubation anesthesia. Arch Otolaryngol. 1961 Sep;74:323–332. doi: 10.1001/archotol.1961.00740030330015. [DOI] [PubMed] [Google Scholar]
  15. MEADE J. W. Tracheotomy--its complications and their management. A study of 212 cases. N Engl J Med. 1961 Sep 14;265:519–523. doi: 10.1056/NEJM196109142651103. [DOI] [PubMed] [Google Scholar]
  16. McClelland R. M. Complications of tracheostomy. Br Med J. 1965 Sep 4;2(5461):567–569. doi: 10.1136/bmj.2.5461.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nadel J. A., Wolfe W. G., Graf P. D. Powdered tantalum as a medium for bronchography in canine and human lungs. Invest Radiol. 1968 Jul-Aug;3(4):229–238. doi: 10.1097/00004424-196807000-00001. [DOI] [PubMed] [Google Scholar]
  18. Nadel J. A., Wolfe W. G., Graf P. D., Youker J. E., Zamel N., Austin J. H., Hinchcliffe W. A., Greenspan R. H., Wright R. R. Powdered tantalum. N Engl J Med. 1970 Aug 6;283(6):281–286. doi: 10.1056/NEJM197008062830603. [DOI] [PubMed] [Google Scholar]
  19. PEARCE D. J., WALSH R. S. Respiratory obstruction due to tracheal granuloma after tracheostomy. Lancet. 1961 Jul 15;2(7194):135–136. doi: 10.1016/s0140-6736(61)92651-4. [DOI] [PubMed] [Google Scholar]
  20. Pearson F. G., Goldberg M., da Silva A. J. Tracheal stenosis complicating tracheostomy with cuffed tubes. Clinical experience and observations from a prospective study. Arch Surg. 1968 Sep;97(3):380–394. doi: 10.1001/archsurg.1968.01340030040002. [DOI] [PubMed] [Google Scholar]
  21. Stiles P. J. Tracheal lesions after tracheostomy. Thorax. 1965 Nov;20(6):517–522. doi: 10.1136/thx.20.6.517. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES