Cases reported "Burns, Inhalation"

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1/8. Symptomatic tracheal stenosis in burns.

    tracheal stenosis in burns is rare and usually results from prolonged intubation or tracheostomy. inhalation injury itself has the potential risk of tracheal stenosis. We reviewed the records of 1878 burn patients during 1987 to 1995 and found seven with tracheal stenosis (0.37%) after an average of 4.4 years follow up. There were 4 males and 3 females with an average age of 27.3 years. The tracheal stenosis developed 1-22 months after burn (average 7 months). Five patients had their inhalation injury confirmed by bronchoscopic examination. The incidence of tracheal stenosis among inhalation injury patients was 5.49% (5/92). Six patients needed intubation in the initial stage either for respiratory distress or prophylaxis, with an average duration of 195.2 h. In addition to prolonged intubation, the presence of inhalation injury, repeated intubations and severe neck scar contractures are also contributors to tracheal stenosis in burns. We favor T-tube insertion as the first treatment choice; permanent tracheostomy was unsatisfactory in our study.
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ranking = 1
keywords = tracheal stenosis, stenosis
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2/8. Surfactant treatment in a pediatric burn patient with respiratory failure.

    This report describes surfactant treatment in a burned infant with severe respiratory failure. In this patient the instillation of surfactant rapidly improved compliance, oxygen index (OI), and alveolar-capillary oxygen gradient (AaDO2), while the need for oxygen supplementation and peak positive pressure drastically decreased. The treatment was repeated after 12 hours. Although the baby had severe clinical course complications as a Gram-negative sepsis and a subglottic stenosis, she was weaned from oxygen therapy and mechanical ventilation in few weeks. Surfactant dysfunctions seem to play a central role in the respiratory insufficiency of burned patients, and its exogenous replacements could improve their outcome.
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ranking = 9.5339311857781E-5
keywords = stenosis
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3/8. Successful reconstruction of extensive laryngotracheal strictures after inhalation burn injury: report of a case.

    We report a rare case of long segmental laryngotracheal stenosis following inhalation burn injury. The patient presented 2 months after his injury with progressive stridor and dyspnea necessitating tracheostomy. A computed tomographic scan of the neck revealed stenosis extending from the vocal cords to the top of the sternum. Repair was successfully carried out with multiple surgical procedures employing hinge-flap closure tented with autogenous tissue.
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ranking = 0.1111958571661
keywords = tracheal stenosis, stenosis
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4/8. Long-term management of extensive tracheal stenosis due to formic acid chemical burn.

    We report on a 26-year-old woman who during early infancy (6 months) suffered from a chemical burn of the skin and upper airways due to spill of formic acid powder. Twenty years after the initial injury, she presented with dyspnea and stridor due to severe tracheal stenosis. Several interventional bronchoscopic manipulations were initiated: incision of the stenotic lesion with Nd:YAG laser and dilatation with a valvuloplasty balloon which enabled silicone stent placement which was subsequently kept in place for 3 years. Complications during the 4th year after stenting led to the successful replacement of this stent by two autoexpandable metallic stents covering the total length of the trachea from the subglottic area to the carina. In post-burn inhalation injuries, a complex inflammatory process may be active for many years after the initial insult. These injuries respond to prolonged tracheal stenting and a conservative approach is recommended.
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ranking = 0.55550258927119
keywords = tracheal stenosis, stenosis
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5/8. Treatment of combined subglottic and critically low tracheal stenoses secondary to burn inhalation injury.

    We report a case of combined severe subglottic and lower tracheobronchial stenoses after an inhalation burn injury. The patient was successfully treated by the insertion of a bifurcated silicone rubber stent. The proximal limb of the silicone tube was used to stent the subglottic stenosis after it had been resected, a treatment option not previously reported. It is speculated that the diffuse airway damage resulted from a combination of thermal injury, mechanical trauma and infection. The relatively late symptomatic presentation of the lower tracheal stricture is stressed and the treatment options discussed.
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ranking = 9.5339311857781E-5
keywords = stenosis
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6/8. Airway complications from free-basing cocaine.

    The majority of the deaths due to fires result from smoke inhalation, hypoxia, and systemic toxicity. Lower airway injury from chemical byproducts carried in the smoke is less frequent and thermal injury to the lower airways is a rare occurrence. We report a case of severe thermal injury to the conducting airways due to either inhalational injury or to intratracheal ignition of the ether vehicle used in free-basing cocaine resulting in severe reactive airways disease and tracheal stenosis requiring reconstructive surgery.
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ranking = 0.11110051785424
keywords = tracheal stenosis, stenosis
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7/8. The management of laryngotracheal stenosis in burned patients.

    Following burns of the upper respiratory tract, laryngotracheal stenosis is associated with considerable morbidity. This paper deals with the cumulative effect of various pathologic processes involved in burn trauma of the upper airway. Emphasis is placed on the extended use of endotracheal intubation and the avoidance of tracheostomy whenever possible. When laryngotracheal stenosis develops, it may be safely and successfully treated by prolonged stenting, as has been borne out by our experience with the T-shaped silicone tubes. Limited reconstructive procedures can be performed to facilitate proper placement of the stent. In our opinion, laryngotracheal resection and reconstruction are not the procedures of choice in burn cases. Our experience in following the preceding guidelines is described. Three illustrative cases serve to exemplify the difficulties and problems involved in the various stages of treatment and the results obtained. The patients are symptom-free 18 to 24 months following stenting, and all enjoy an adequate airway and good voice. There were no complications resulting from this treatment and we suggest that it is worthy of trial.
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ranking = 0.66660310712543
keywords = tracheal stenosis, stenosis
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8/8. Tracheoplasty for tracheal stenosis in the pediatric burned patient.

    Until recently, the only therapy available for a tracheal stricture has been repeated dilations of the stenotic area or resection and anastomosis. Upper-airway burns in the pediatric patient have occasionally resulted in tracheal stenosis. Two children with a long tracheal stenosis secondary to inhalation injury have been successfully treated surgically. A costal cartilage graft has been used in these two children in the management of a long tracheal stenosis. Both have an adequate airway, and future surgical correction of a subglottic stenosis is planned for both. The results, although initially successful, will need to be tested by time before they can be considered the definitive treatment for long areas of tracheal stenosis.
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ranking = 0.88889948214576
keywords = tracheal stenosis, stenosis
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