Tracheal Resection of a Stomal Stricture and Repair Following a Tracheostomy 2 Patterson GA1, Yee A2 February 13, 2016Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Tracheotomy and endotracheal intubation continues to be most common cause for tracheal stenosis and management involves tracheal resection and reapproximation. In this case, the patient presented with a history of multiple cardiac surgical procedures. She undergone a tracheostomy and developed recent symptoms of stridor. Imaging studies demonstrated a typical tracheostomy and stromal stricture. Surgical management involved tracheal resection and primary anastomosis. This video details the specifics for a tracheal resection from incision to closure.Keywords: tracheal resectionstridortracheal stenosisstomal stricturetracheostomy Standard Edition Table of Contents- Slow down- Frustration00:00:00 - Introduction00:00:20 - Incision00:00:28 - Superficial Dissection to Elevate Subplatysmal Flaps00:01:26 - Subplatysmal Dissection00:02:48 - Dividing the Infrahoyd Muscles along the Midline00:03:21 - Dividing the Thyroid Isthmus00:03:35 - Identifying the Tracheal Stricture and Mobilizing Away from Tracheal Wall00:03:54 - Finger Dissection along the Trachea00:04:06 - Anterior Traction Suture and Exam of Tracheal Stricture and Adjacent Landmarks00:04:25 - Partial Incision Proximal to the Stricture00:04:51 - Anterior Traction Sutures on the Proximal Airway and Stricture00:05:25 - Retracting the Endotracheal Tube into the Proximal Trachea00:05:39 - Partial Incision Distal to the Stricture00:06:00 - Anterior Traction Sutures on the Distal Airway00:06:23 - Insertion of Cross Field Ventilation Tubing00:06:30 - Elevating the Stricture through Dividing the Posterior Membranous Airway00:06:58 - Examination of Excised Tracheal Stricture00:07:04 - Additional Traction Sutures on the Proximal Airway00:07:17 - Closing the Posterior Membranous Airway with 4-0 PDS00:08:27 - Closing the Partial Anterior Cartilaginous Airway with 3-0 Vicryl00:09:16 - Removing the Cross Field Tubing and Advancing the Endotracheal Tube00:09:42 - Securing the Anterior Sutures of the Cartilaginous Airway00:10:01 - Testing Trachea Repair under Saline for Air Leaks00:10:06 - Sewing the Infrahoyd Muscles to the An terior Aspect of the Airway00:11:02 - Closing Platysma with a Running Suture00:11:52 - Subcuticular Closure00:13:24 - Guardian Stitch between the Chin and Anterior Chest Overlying the Sternal Manubrial Junction00:13:57 - Credits You must login to view the full article and extended video on this page. Leave a Comment Cancel replyYou must be logged in to post a comment.