Compression Stenosis Of The Trachea


Categories: CHRONIC STENOSIS OF THE LARYNX AND TRACHEA
Sources: 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 neoplasms,

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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