Closed cervical tracheal rupture caused by trauma is a rare clinical emergency severe disease. We report the anesthesia experience of a 37-year-old male patient undergoing emergency tracheal reconstruction surgery due to a traumatic neck closed tracheal complete rupture. The patient was conscious and hoarse when entering the operation room, complained of dyspnea during inspirations, maxillofacial neck swelling, obvious subcutaneous crepitus of neck by palpation, and limited mouth opening. Mallampati grade III, neck movement was limited due to pain, and difficulty in intubation was considered in combination with the patient's neck, chest computed tomography (CT) and airway evaluation. Failure of intubation after the administration of muscle relaxants may result in rapid difficulty in establishing a surgical airway. Intubation under the guidance of awake bronchoscopy may fail to reach the distal tracheal end, and may lead to increased airway injury and inability to maintain ventilation. In order to ensure the safety of patient, it was decided to explore the neck incision under local anesthesia, find the broken end of the trachea, insert the endotracheal tube at the distal end, and then perform general anesthesia to control the airway. Intraoperative vital signs were stable of the patient. After the operation, the tracheostomy tube was changed and transferred the patient to ICU for further treatment. Patients with cervical tracheal rupture, establishing airway under local anesthesia with preserve the patient's spontaneous breathing combined sedation is a selection of security technology.
Published in | International Journal of Anesthesia and Clinical Medicine (Volume 11, Issue 1) |
DOI | 10.11648/j.ijacm.20231101.20 |
Page(s) | 44-48 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Tracheal Rupture, Neck Closed Injury, Tracheal Reconstruction, Anesthesia Management
[1] | Sethi R, Khatib D, Kligerman M, et al. Laryngeal fracture presentation and management in United States emergency rooms: Laryngeal Fractures in the ED [J]. The Laryngoscope, 2019, 129 (10): 2341-2346. |
[2] | Liu IY, Mendelsohn AH, Ching H, et al. Staged laryngotracheoplasty in adult laryngotracheal stenosis: predictors of long-term decannulation [J]. JAMA Otolaryngology–Head & Neck Surgery, 2015, 141 (3): 211-218. |
[3] | Raucher D, Sheetz MP. Characteristics of a membrane reservoir buffering membrane tension. [J]. Biophysical Journal, 1999, 77 (4): 1992-2002. |
[4] | Lorenz, Robert R. Adult laryngotracheal stenosis: etiology and surgical management. [J]. Current Opinion in Otolaryngology & Head & Neck Surgery, 2003, 11 (6): 467-72. |
[5] | Wasif M, Dhanani R, Ghaloo SK, et al. Management of Laryngotracheal trauma: A review of current trends and future Directions [J]. Journal of the Pakistan Medical Association, 2020, 7 0 (Suppl 1)(2): S60-S64. |
[6] | Klein U, Karzai W, Bloos F, et al. Role of Fiberoptic Bronchoscopy in Conjunction with the Use of Double-lumen Tubes for Thoracic Anesthesia [J]. Anesthesiology, 1998, 88 (2): 346350. |
[7] | Shi J, Uyeda JW, Duran-Mendicuti A, et al. Multidetector CT of laryngeal injuries: principles of injury recognition [J]. Radiographics, 2019, 39 (3): 879-892. |
[8] | Ye D, Shen Z, Zhang Y, et al. Clinical features and management of closed injury of the cervical trachea due to blunt trauma [J]. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2013, 21 (1): 1-7. |
[9] | Glinjongol C, Pakdirat B. Management of tracheobrochial injuries: A 10- year experience at Ratchaburi Hospital [J]. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005, 88 (1): 32-40. |
[10] | Reeve NH, Kim Y, Kahane JB, et al. Management of traumatic laryngotracheal separation: case series and review [J]. Journal of Trauma and Acute Care Surgery, 2021, 90 (6): e132-e137. |
[11] | Kahue CN, Gelbard A. Laryngeal trauma with and without tracheal separation [J]. Operative Techniques in Otolaryngology-Head and Neck Surgery, 2017, 28 (4): 244-251. |
[12] | Jain U, McCunn M, Smith CE, et al. Management of the traumatized airway [J]. Anesthesiology, 2016, 124 (1): 199-206. |
[13] | Dada LA, Sznajder JI. Mechanisms of pulmonary edema clearance during acute hypoxemic respiratory failure: Role of the Na, K-ATPase [J]. Critical Care Medicine, 2003, 31 (4 Suppl): S248-52. |
[14] | Slinger P, Scott W. Arterial oxygenation during one-lung ventilation. A comparison of enflurane and isoflurane. [J]. Anesthesiology, 1995, 82 (4): 940-6. |
[15] | Conti M, Porte H, Wurtz A. Management of tracheobronchial ruptures in critically ill patients [J]. Minerva Anestesiologica, 2007, 73 (7-8): 443. |
[16] | Jamal-Eddine H, Ayed AK, Peri M, et al. Injuries to the major airway after blunt thoracic trauma in children: review of 2 cases [J]. Journal of Pediatric Surgery, 2007, 42 (4): 719721. |
[17] | Eipe N, Choudhrie A. Tracheal rupture in a child with blunt chest injury [J]. Pediatric Anesthesia, 2007, 17 (3): 273-277. |
[18] | Gries C, Pierson D. Tracheal rupture resulting in life-threatening subcutaneous emphysema. [J]. Respiratory Care, 2007, 52 (2): 191-5. |
[19] | Ochroch DSSA. Anesthesia for the Patient with Tracheal Stenosis [J]. Anesthesiology Clinics, 2010. |
APA Style
Jiaqi Yang, Yang Chen, Yu Li. (2023). Anesthesia Management of Trachea Reconstruction in a Patient with Traumatic Neck Closed Tracheal Complete Rupture. International Journal of Anesthesia and Clinical Medicine, 11(1), 44-48. https://doi.org/10.11648/j.ijacm.20231101.20
ACS Style
Jiaqi Yang; Yang Chen; Yu Li. Anesthesia Management of Trachea Reconstruction in a Patient with Traumatic Neck Closed Tracheal Complete Rupture. Int. J. Anesth. Clin. Med. 2023, 11(1), 44-48. doi: 10.11648/j.ijacm.20231101.20
AMA Style
Jiaqi Yang, Yang Chen, Yu Li. Anesthesia Management of Trachea Reconstruction in a Patient with Traumatic Neck Closed Tracheal Complete Rupture. Int J Anesth Clin Med. 2023;11(1):44-48. doi: 10.11648/j.ijacm.20231101.20
@article{10.11648/j.ijacm.20231101.20, author = {Jiaqi Yang and Yang Chen and Yu Li}, title = {Anesthesia Management of Trachea Reconstruction in a Patient with Traumatic Neck Closed Tracheal Complete Rupture}, journal = {International Journal of Anesthesia and Clinical Medicine}, volume = {11}, number = {1}, pages = {44-48}, doi = {10.11648/j.ijacm.20231101.20}, url = {https://doi.org/10.11648/j.ijacm.20231101.20}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20231101.20}, abstract = {Closed cervical tracheal rupture caused by trauma is a rare clinical emergency severe disease. We report the anesthesia experience of a 37-year-old male patient undergoing emergency tracheal reconstruction surgery due to a traumatic neck closed tracheal complete rupture. The patient was conscious and hoarse when entering the operation room, complained of dyspnea during inspirations, maxillofacial neck swelling, obvious subcutaneous crepitus of neck by palpation, and limited mouth opening. Mallampati grade III, neck movement was limited due to pain, and difficulty in intubation was considered in combination with the patient's neck, chest computed tomography (CT) and airway evaluation. Failure of intubation after the administration of muscle relaxants may result in rapid difficulty in establishing a surgical airway. Intubation under the guidance of awake bronchoscopy may fail to reach the distal tracheal end, and may lead to increased airway injury and inability to maintain ventilation. In order to ensure the safety of patient, it was decided to explore the neck incision under local anesthesia, find the broken end of the trachea, insert the endotracheal tube at the distal end, and then perform general anesthesia to control the airway. Intraoperative vital signs were stable of the patient. After the operation, the tracheostomy tube was changed and transferred the patient to ICU for further treatment. Patients with cervical tracheal rupture, establishing airway under local anesthesia with preserve the patient's spontaneous breathing combined sedation is a selection of security technology.}, year = {2023} }
TY - JOUR T1 - Anesthesia Management of Trachea Reconstruction in a Patient with Traumatic Neck Closed Tracheal Complete Rupture AU - Jiaqi Yang AU - Yang Chen AU - Yu Li Y1 - 2023/06/10 PY - 2023 N1 - https://doi.org/10.11648/j.ijacm.20231101.20 DO - 10.11648/j.ijacm.20231101.20 T2 - International Journal of Anesthesia and Clinical Medicine JF - International Journal of Anesthesia and Clinical Medicine JO - International Journal of Anesthesia and Clinical Medicine SP - 44 EP - 48 PB - Science Publishing Group SN - 2997-2698 UR - https://doi.org/10.11648/j.ijacm.20231101.20 AB - Closed cervical tracheal rupture caused by trauma is a rare clinical emergency severe disease. We report the anesthesia experience of a 37-year-old male patient undergoing emergency tracheal reconstruction surgery due to a traumatic neck closed tracheal complete rupture. The patient was conscious and hoarse when entering the operation room, complained of dyspnea during inspirations, maxillofacial neck swelling, obvious subcutaneous crepitus of neck by palpation, and limited mouth opening. Mallampati grade III, neck movement was limited due to pain, and difficulty in intubation was considered in combination with the patient's neck, chest computed tomography (CT) and airway evaluation. Failure of intubation after the administration of muscle relaxants may result in rapid difficulty in establishing a surgical airway. Intubation under the guidance of awake bronchoscopy may fail to reach the distal tracheal end, and may lead to increased airway injury and inability to maintain ventilation. In order to ensure the safety of patient, it was decided to explore the neck incision under local anesthesia, find the broken end of the trachea, insert the endotracheal tube at the distal end, and then perform general anesthesia to control the airway. Intraoperative vital signs were stable of the patient. After the operation, the tracheostomy tube was changed and transferred the patient to ICU for further treatment. Patients with cervical tracheal rupture, establishing airway under local anesthesia with preserve the patient's spontaneous breathing combined sedation is a selection of security technology. VL - 11 IS - 1 ER -