Use of a silicone T-tube for management of a tracheal injury in a patient with cervical blunt trauma

• Published in: General thoracic and cardiovascular surgery 2003-10, Vol.51 (10), p.541-544
• Main Authors: Shimizu, Junzo, Hirano, Yasumitsu, Ishida, Yoshinori, Kinoshita, Takahiro, Tatsuzawa, Yasuhiko, Kawaura, Yukimitsu
• Format: Article
• Language: English
• Subjects: Aged; Cartilage; Female; Humans; Neck Injuries - complications; Neck Injuries - therapy; Ostomy; Silicones; Stents; Subcutaneous Emphysema - etiology; Trachea - injuries; Tracheostomy; Tracheotomy; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - therapy
• ISSN: 1344-4964; 1863-6705; 1863-6713
• DOI: 10.1007/s11748-003-0120-6

A 71-year-old woman fell forward hitting the anterior part of her neck against a table. Bronchoscopy revealed deformation of the cartilage crescent in the cervical trachea (suggestive of cartilage contusion) and a longitudinal tear in the membranous region. Because subcutaneous emphysema and dyspnea developed and progressed, we made a tracheostomy and inserted a silicone T-tube through the stoma to relieve intraluminal pressure. This then served as a stent for the airway after the patient had progressed through the acute stage. The subcutaneous emphysema and pneumomediastinum abated gradually during the 7 days after insertion of the T-tube, which remained in the cervical trachea as a tracheal stent for 2 months thereafter. The T-tube is easy to manage and can be inserted through the stoma without major surgery. As an alternative to tracheotomy, the T-tube is nonirritating, allows speech, aspiration of sputum, and respiration through the nasopharynx, and in general requires little if any special maintenance or cleaning. Furthermore, a relatively long T-tube can be used, and so the stent can occupy a longer section of the trachea than can a tracheostomy tube. We recommend the placement of a T-tube to provide a useful stent for cervical tracheal injury.