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The Annals of Thoracic Surgery, Vol 30, 291-296, Copyright © 1980 by The Society of Thoracic Surgeons
MR Johnston, N Loeber, P Hillyer, LW Stephenson and LH Edmunds Jr
Tracheomalacia was created in anesthetized piglets by submucosal resection
of 3 to 5 tracheal cartilages. Measurements of airway pressure and flow
showed that expiratory airway resistance is maximal at low lung volumes and
is significantly increased by creation of the malacic segment. Cervical
flexion increases expiratory airway resistance, whereas hyperextension of
the neck reduces resistance toward normal. External stenting of the malacic
segment reduces expiratory airway resistance, and the combination of
external stenting and hyperextension restores airway resistance to normal
except at low lung volume. Two patients with secondary tracheomalacia
required tracheostomy and could not be decannulated after the indication
for the tracheostomy was corrected. Both were successfully decannulated
after external stenting of the malacic segment with rib grafts.
Postoperative measurements of expiratory pulmonary resistance show a marked
decrease from preoperative measurements. External stenting of symptomatic
tracheomalacia reduces expiratory airway resistance by supporting and
stretching the malacic segment and is preferable to prolonged internal
stenting or tracheal resection.
ARTICLES
External stent for repair of secondary tracheomalacia
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