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Role of newer imaging modalities for airway assessment in dynamic tracheal compression.

Udayakumar P, Srikanti M, Vijayakumar V, Kandappan G - J Anaesthesiol Clin Pharmacol (2014)

Bottom Line: Anesthetic management of a patient with tracheal stenosis is challenging.With our experience in this case, we believe that newer imaging modalities are just an adjunct in the assessment of the compromised airway in case of dynamic compression.Clinical assessment is very important in deciding the plan of management.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.

ABSTRACT
Anesthetic management of a patient with tracheal stenosis is challenging. Though we have newer imaging modalities like multislice, three-dimensional computerized tomography, virtual bronchoscopy to determine the size and anatomy of the airway, it is difficult to accurately predict the distensibility of the trachea with the available preoperative tests. With our experience in this case, we believe that newer imaging modalities are just an adjunct in the assessment of the compromised airway in case of dynamic compression. Clinical assessment is very important in deciding the plan of management.

No MeSH data available.


Related in: MedlinePlus

Three-dimensional Computerized Tomography and corresponding virtual bronchoscopic images of our patient
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Figure 1: Three-dimensional Computerized Tomography and corresponding virtual bronchoscopic images of our patient

Mentions: She was treated elsewhere as bronchial asthma and referred to our center for evaluation of hemoptysis. On examination, she was found to have a swelling in the left lobe of the thyroid, compressing and pushing the trachea to the right. Auscultation of her chest revealed bilateral inspiratory and expiratory wheeze. CT of the neck and thorax revealed an enlarged left lobe of thyroid measuring 3.4 × 3.3 × 3.4 cm with dense nodular calcification, causing short segment external compression and tracheal luminal narrowing. The stenosis extended from upper margins of C7 to T2 vertebrae, with a length of 3.1 cm and minimal diameter of 0.31 cm [Figure 1]. Fine needle aspiration cytology (FNAC) of the swelling revealed colloid goiter and she was posted for a left hemithyroidectomy.


Role of newer imaging modalities for airway assessment in dynamic tracheal compression.

Udayakumar P, Srikanti M, Vijayakumar V, Kandappan G - J Anaesthesiol Clin Pharmacol (2014)

Three-dimensional Computerized Tomography and corresponding virtual bronchoscopic images of our patient
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927268&req=5

Figure 1: Three-dimensional Computerized Tomography and corresponding virtual bronchoscopic images of our patient
Mentions: She was treated elsewhere as bronchial asthma and referred to our center for evaluation of hemoptysis. On examination, she was found to have a swelling in the left lobe of the thyroid, compressing and pushing the trachea to the right. Auscultation of her chest revealed bilateral inspiratory and expiratory wheeze. CT of the neck and thorax revealed an enlarged left lobe of thyroid measuring 3.4 × 3.3 × 3.4 cm with dense nodular calcification, causing short segment external compression and tracheal luminal narrowing. The stenosis extended from upper margins of C7 to T2 vertebrae, with a length of 3.1 cm and minimal diameter of 0.31 cm [Figure 1]. Fine needle aspiration cytology (FNAC) of the swelling revealed colloid goiter and she was posted for a left hemithyroidectomy.

Bottom Line: Anesthetic management of a patient with tracheal stenosis is challenging.With our experience in this case, we believe that newer imaging modalities are just an adjunct in the assessment of the compromised airway in case of dynamic compression.Clinical assessment is very important in deciding the plan of management.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.

ABSTRACT
Anesthetic management of a patient with tracheal stenosis is challenging. Though we have newer imaging modalities like multislice, three-dimensional computerized tomography, virtual bronchoscopy to determine the size and anatomy of the airway, it is difficult to accurately predict the distensibility of the trachea with the available preoperative tests. With our experience in this case, we believe that newer imaging modalities are just an adjunct in the assessment of the compromised airway in case of dynamic compression. Clinical assessment is very important in deciding the plan of management.

No MeSH data available.


Related in: MedlinePlus