Iatrogenic aspiration of custom-made keel: A case report

Introduction: Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during t...

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Main Authors: Sharouny, H., Omar, R.
Format: Article
Published: Kowsar Publishing 2014
Subjects:
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author Sharouny, H.
Omar, R.
author_facet Sharouny, H.
Omar, R.
author_sort Sharouny, H.
collection UM
description Introduction: Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during the later stage. They can be put in place either via the endoscopic approach or through a micro thyroidotomy and are held in place with a heavy suture through cricothyroid and thyrohyoid membranes. They are left in place for two to four weeks, and then removed through the endoscopic approach under general anesthetics. Case Presentation: We report on a case of anterior glottis stenosis with keel aspiration for two weeks, after endoscopic CO2 laser resection of the stenotic section and keel placement. The patient was admitted to our center, where bronchoscopy was performed and the keel was removed. A new custom-made silastic keel was properly placed in raw areas and fixed to the skin with suture through the cricothyroid and thyrohyoid membranes. The keel was removed three weeks later. Conclusions: Endoscopic keel placement should be done with heavy suture through cricothyroid and thyrohyoid membranes. Surgeons should suture the keel to the anterior laryngeal wall with specially designed Lichtenberger's needle-carriers to prevent complications such as keel aspiration, adhesion formation and imposing a second trip under general anesthetics, which put the patient at increased risk. The false vocal cord microflaps, as biological keels and a relatively new method may replace silastic keel placement in the future.
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spelling um.eprints-155542016-01-20T10:32:43Z http://eprints.um.edu.my/15554/ Iatrogenic aspiration of custom-made keel: A case report Sharouny, H. Omar, R. T Technology (General) TL Motor vehicles. Aeronautics. Astronautics Introduction: Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during the later stage. They can be put in place either via the endoscopic approach or through a micro thyroidotomy and are held in place with a heavy suture through cricothyroid and thyrohyoid membranes. They are left in place for two to four weeks, and then removed through the endoscopic approach under general anesthetics. Case Presentation: We report on a case of anterior glottis stenosis with keel aspiration for two weeks, after endoscopic CO2 laser resection of the stenotic section and keel placement. The patient was admitted to our center, where bronchoscopy was performed and the keel was removed. A new custom-made silastic keel was properly placed in raw areas and fixed to the skin with suture through the cricothyroid and thyrohyoid membranes. The keel was removed three weeks later. Conclusions: Endoscopic keel placement should be done with heavy suture through cricothyroid and thyrohyoid membranes. Surgeons should suture the keel to the anterior laryngeal wall with specially designed Lichtenberger's needle-carriers to prevent complications such as keel aspiration, adhesion formation and imposing a second trip under general anesthetics, which put the patient at increased risk. The false vocal cord microflaps, as biological keels and a relatively new method may replace silastic keel placement in the future. Kowsar Publishing 2014 Article PeerReviewed Sharouny, H. and Omar, R. (2014) Iatrogenic aspiration of custom-made keel: A case report. Iranian Red Crescent Medical Journal, 16 (12).
spellingShingle T Technology (General)
TL Motor vehicles. Aeronautics. Astronautics
Sharouny, H.
Omar, R.
Iatrogenic aspiration of custom-made keel: A case report
title Iatrogenic aspiration of custom-made keel: A case report
title_full Iatrogenic aspiration of custom-made keel: A case report
title_fullStr Iatrogenic aspiration of custom-made keel: A case report
title_full_unstemmed Iatrogenic aspiration of custom-made keel: A case report
title_short Iatrogenic aspiration of custom-made keel: A case report
title_sort iatrogenic aspiration of custom made keel a case report
topic T Technology (General)
TL Motor vehicles. Aeronautics. Astronautics
work_keys_str_mv AT sharounyh iatrogenicaspirationofcustommadekeelacasereport
AT omarr iatrogenicaspirationofcustommadekeelacasereport