Compression Stenosis Of The Trachea
Categories: CHRONIC STENOSIS OF THE LARYNX AND TRACHEASources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Decannulation in these cases
can only follow the removal of the compressive mass, which may be
thymic, neoplastic, hypertrophic or inflammatory. Glandular disease
may be of the Hodgkins' type. Thymic compression yields readily to
radium and the roentgenray, and the tuberculous and leukemic
adenitides are sometimes favorably influenced by the same agents.
Surgery will relieve the compression of struma and benign neoplas
and may be indicated in certain neoplasms of malignant origin. The
possible coexistence of laryngeal paralysis with tracheal compression
is frequently overlooked by the surgeon. Monolateral or bilateral
paralysis of the larynx is by no means an uncommon postoperative
sequel to thyroidectomy, even though the recurrent nerves have been in
no way injured at operation. Probably a localized neuritis, a
cicatricial traction, or inclusion of a nerve trunk accounts for most
of these cases.
Hyperplastic and cicatricial chronic stenoses preventing
decannulation may be classified etiologically as follows:
1. Tuberculosis
2. Lues
3. Scleroma
4. Acute infectious diseases
(a) Diphtheria
(b) Typhoid fever
(c) Scarlet fever
(d) Measles
(e) Pertussis
5. Decubitus
(a) Cannular
(b) Tubal
6. Trauma
(a) Tracheotomic
(b) Intubational
(c) Operative
(d) Suicidal and homicidal
(e) Accidental (by foreign bodies, external violence, bullets,
etc.)
Most of the organic stenoses, other than the paralytic and neoplastic
forms, are the result of inflammation, often with ulceration and
secondary changes in the cartilages or the soft tissues.
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