Treatment of traumatic tracheal collapse with extraluminal titanium mesh screens

Abstract

Summary A 12‐year‐old Thoroughbred gelding presented with a history of exercise intolerance and inspiratory stridor. Physical examination revealed a blunt crush injury to the ventral neck and underlying trachea of unknown duration. Tracheoscopy revealed a grade 3 tracheal collapse. Surgical management of the case involved placement of extraluminal titanium mesh screens circumferentially around the trachea for complete support. During the period of hospitalisation, the only post operative complication was seroma formation, which resolved with routine care. Follow‐up after 5 years revealed no further evidence of exercise intolerance, inspiratory dyspnoea or stridor. The horse returned to his previous level of work as a show hunter.

Management of apposing, full‐thickness tracheal perforations in two horses

“…However, unstable tracheal rings should be repaired using suture or alternatively intraluminal titanium mesh screens (Scott ; Graham et al . ). If fractured tracheal rings are not stabilised, malalignment can result in a reduction in the diameter of the trachea, or the formation of a chondroma (Haynes ).…”

“…While this condition is usually caused by a kick or other trauma by running into a fence in horses (Trostle et al 1995;Saulez et al 2005Saulez et al , 2009, iatrogenic perforations of the trachea have also been reported following endotracheal intubation (Saulez et al 2009). Single perforations have been reported to occur dorsally (Gronvold et al 2005;Saulez et al 2005Saulez et al , 2009), ventrally (Graham et al 2010) or laterally (Caron and Townsend 1984). The horses described in this report had concurrent dorsal and ventral perforations, a rarely reported finding (Cudmore and Nath 2012).…”

“…As shown in this report, cases of tracheal perforation may have no external wound and present only as subcutaneous emphysema. Upper airway endoscopy was noted to be invaluable in making a diagnosis in determining the size and exact location of the injury (Caron and Townsend 1984;Saulez et al 2009;Graham et al 2010). Ultrasonography can also be utilised to make a diagnosis and determine an approximate location for the injury (Rojman et al 2009;Stick 2012).…”

“…On removal of the tracheostomy tube, granulation tissue had filled in ventral to the defect within the subcutaneous tissues and the cartilage appeared stable. However, unstable tracheal rings should be repaired using suture or alternatively intraluminal titanium mesh screens (Scott 1978;Graham et al 2010). If fractured tracheal rings are not stabilised, malalignment can result in a reduction in the diameter of the trachea, or the formation of a chondroma (Haynes 1984).…”

Diagnosing the ‘hidden’ consequences of cervical trauma

“…This is particularly true in cases of blunt trauma that damages the trachea or oesophagus. Injury to the tracheal rings can occur without perforation and may not be noticed initially, as was the case with the horse described in the article by Graham et al . (2010) in this issue.…”