A life with two tracheal rings

 

An 82-year-old patient was referred to our outpatient clinic by the orthopedics for airway evaluation prior to an intubation. Due to a stenosis of the spinal canal the patient was planned to undergo a stabilization of the spine.

30 years ago, the patient had a severe car accident leading to a complex polytrauma. As part of the treatment, a tracheostomy was necessary, which then led to recurrent tracheal stenosis. Several operations were performed including a tracheal segment resection.

During this time, a series of wound healing disorders led to an unstable airway, so finally the treatment was shifted to palliative care. As a last attempt, an end-to-end anastomosis of both tracheal endings was performed after mobilization of the bronchi.

Two tracheal rings remained. The postoperative course was without complications, and the patient had no airway or breathing problems afterwards. In our transnasal flexible endoscopy, we observed a normal larynx, with the two remaining tracheal rings and the carina visible in the subglottic region. The planned spinal operation including orotracheal intubation went well.

Tracheal surgery is one of the most risky procedures in otolaryngology. The trachea has a length of 10-13 cm and a diameter of 1.5-2 cm, with up to 20 tracheal rings.

Stenosis can be removed up to a maximum of 4-6 cm length, to enable a tension-free anastomosis.

Publication History

Article published online:
24 May 2022

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