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- Francesco Paolo Caronia, Domenico Loizzi, Tommaso Nicolosi, Sergio Castorina, and Alfonso Fiorelli.
- Thoracic Surgery Unit, Istituto Oncologico del Mediterraneo, Catania, Italy.
- Head Neck. 2017 Dec 1; 39 (12): E114-E117.
BackgroundWe reported a tubeless tracheal resection and reconstruction for the management of benign posttracheostomy tracheal stenosis.MethodsA 34-year-old man with stridor, severe respiratory distress, and recurrent pneumonia was referred to our attention for treatment of benign posttracheostomy tracheal stenosis. As he refused general anesthesia, the procedure was performed while he was under local anesthesia and spontaneous ventilation.ResultsSedation was started with infusion of dexmedetomidine 0.7 mg/kg/min and of remifentanil 0.5 mg/kg/h; also, 40%-50% oxygen was delivered using a laryngeal mask at a rate of 3.5 mL/min. An additional dose of 2% lidocaine was injected into the surgical site during the operation to achieve an adequate level of anesthesia. A standard resection and reconstruction of trachea was carried out and no recurrence was found in the follow-up of 41 months.ConclusionTubeless tracheal surgery seems to be a feasible and safe procedure. Larger prospective series should validate our results.© 2017 Wiley Periodicals, Inc.
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