Chapter 51: Tracheal + Laryngeal Stenosis

Question 1

Put roughly, if you’re looking through the vocal cords and you see evidence of a narrowed airway, almost like staring through a black hole, your patient likely has:

Answer 1

tracheal or laryngeal stenosis

Question 2

If there is evidence of narrowing at the level of the vocal cords, what kind of stenosis?

Answer 2

Laryngeal stenosis

Question 3

If there is evidence of narrowing about 3 cm below the vocal cords, what kind of stenosis?

Answer 3

Tracheal stenosis

Question 4

Early management technique of airway stenosis?

Answer 4

Dilation

Question 5

These tools are used in what treatment of airway stenosis?

Answer 5

Dilation–an early managment option

Question 6

Example of tool used to treat airway stenosis?

Answer 6

Stent: may be permanent or temporary

Question 7

What occurs during a tracheal or cricotrachel resection?

Answer 7

Surgeon excises lesion and reattaches airway at that point; major surgery to treat airway stenosis

Question 8

Three methods to determine level of resection in a patient that has had a tracheal or cricotracheal resection in the event of airway stenosis?

Answer 8

Look at PMH for an operation note or letter.

Call for a CXR to visualize stent or marker clips.

Call for a CT scan.

Question 9

Does a tracheal resection imply a difficult airway?

Answer 9

Not necessarily, but you do need to avoid placing the cuff at the level of the resection suture line to prevent any additional pressure on that weak portion of the trachea

Question 10

What is your main concern about ventilating a patient that has had a tracheal or cricotracheal resection in the past?

Answer 10

Airway pressure; must keep low because trachea is weak

Question 11

How should you confirm appropriate ETT level after intubating a patient that has had a tracheal or cricotracheal resection?

Answer 11

Use FFOB to confirm placement.