Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis †

Toyota, Kosaku; Uchida, Hiroaki; Okumura, Hiroshi; Motooka, Akihiro; Sakura, Shinichi; Saito, Yoji

doi:10.1093/bja/aeh283

Cited by 25 publications

(16 citation statements)

References 6 publications

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“…Sagittal or coronal images reconstructed from thin-section images were reformatted to reveal the three-dimensional morphology of the lesion and to allow discrimination from the mass. The three-dimensional morphology of the lesion has the potential to represent the tracheobronchial invasion of the mass more accurately [18, 19]. The accuracy of direct invasion using three-dimensional CT may be better that that of conventional axial images only.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Preoperative Endobronchial Ultrasound for Airway Invasion around the Trachea: Esophageal Cancer and Thyroid Cancer

et al. 2006

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Background: It is important to confirm preoperative tracheobronchial invasion to enable the selection of the most appropriate treatment. Objective: This study was performed to compare the usefulness of computed tomography (CT), magnetic resonance image (MRI) and bronchoscopy by endobronchial ultrasonography (EBUS) for the assessment of invasion of thyroid or esophageal cancer in cases with suspected tracheobronchial invasion. Methods: In cases with suspected contact between the tumor and tracheobronchial wall, CT, MRI and EBUS indicated deformity of the tracheobronchial wall due to the adjacent mass. The final diagnosis was based on surgical and histological results, and/or clinical follow-up. Results: Fifty-four patients were included in this study. Based on the findings of CT, MRI and EBUS, invasion was suspected in 29, 28 and 25 patients, respectively. Seventeen patients did not undergo surgery based on the results of CT, MRI and bronchoscopy with EBUS. Final diagnosis was intact trachea or bronchial adventitia in 26 patients and invasion in 28 patients. The sensitivity and specificity of CT, MRI and EBUS for invasion were 59 and 56, 75 and 73, and 92 and 83%, respectively. The accuracy of EBUS was significantly greater than that of CT in the present study (p = 0.0011). The accuracy of EBUS was significantly different from that of CT and MRI in the surgically treated patients (p = 0.005 and p = 0.032, respectively). Conclusion: EBUS is the most useful technique for determining the depth and extent of tumor invasion into the airway wall. The combination of MRI and EBUS will contribute to surgical planning in patients with esophageal and thyroid cancer.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Preoperative Endobronchial Ultrasound for Airway Invasion around the Trachea: Esophageal Cancer and Thyroid Cancer

et al. 2006

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“…Multi-slice CT, which can be reconstituted with three-dimensional (3D) images, can provide a virtual bronchoscopic view [1]. However, because our patient presented as an emergency case, a 3D-image reconstruction was not performed.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic manipulation in extreme airway stenosis: a case report

et al. 2014

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IntroductionAnesthetic management with airway stenosis is challenging. Techniques for maintaining spontaneous respiration are required under sedative and analgesic conditions.Case presentationA 35-year-old Chinese woman presented to our hospital with difficulty breathing. Computerized tomography showed a tumor in the frontal area of her neck, which was causing extreme narrowing of her trachea. She was immediately scheduled for emergency surgery to remove the tumor. Fiberscopic intubation was carefully performed with dexmedetomidine sedation and remifentanil analgesia. Spontaneous respiration was successfully maintained.ConclusionIn cases of extreme airway stenosis, intubation can be safely achieved with dexmedetomidine sedation and remifentanil analgesia.

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“…Toyoto et al ., used a 5.5 mm ID reinforced endotracheal tube with an external diameter of 7.5 mm in their patient whose CT image showed the narrowest portion as being 2.6 mm. [7]…”

Section: Discussionmentioning

confidence: 99%

Role of newer imaging modalities for airway assessment in dynamic tracheal compression

Udayakumar

Srikanti

Vijayakumar

et al. 2014

J Anaesthesiol Clin Pharmacol

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Anesthetic management of a patient with tracheal stenosis is challenging. Though we have newer imaging modalities like multislice, three-dimensional computerized tomography, virtual bronchoscopy to determine the size and anatomy of the airway, it is difficult to accurately predict the distensibility of the trachea with the available preoperative tests. With our experience in this case, we believe that newer imaging modalities are just an adjunct in the assessment of the compromised airway in case of dynamic compression. Clinical assessment is very important in deciding the plan of management.

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Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis †

Cited by 25 publications

References 6 publications

Usefulness of Preoperative Endobronchial Ultrasound for Airway Invasion around the Trachea: Esophageal Cancer and Thyroid Cancer

Usefulness of Preoperative Endobronchial Ultrasound for Airway Invasion around the Trachea: Esophageal Cancer and Thyroid Cancer

Anesthetic manipulation in extreme airway stenosis: a case report

Role of newer imaging modalities for airway assessment in dynamic tracheal compression

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