Tracheal Laceration Related to Endotracheal Intubation

IMAGES However, 48 hours after the operation, she had dyspnea along with subcutaneous emphysema on her shoulder (Fig. 1). Diagnostic bronchoscopy revealed an approximately 1.5-cm-sized vertical tracheal laceration above the carina with split thickness (Fig. 2). She was started on antibiotics, O2 inhalation, expectorants and non-per oral. The emphysema spontaneously resolved. The patient was discharged uneventfully on postoperative day 7. Many operations in plastic surgery are simple and quick. However, general endotracheal intubation may be required for various reasons. Therefore, it is important for a plastic surgeon operating on the face to be familiar with the complications of intubation. The incidence of postintubation tracheal laceration is reported to be approximately 1/20,000 [1]. Thus far, the cause of this laceration has not been definitely established, but the condition is generally attributed to pre-existing tracheal wall weakness, difficult intubation, emergency intubation, inexperience of the health professional, a double-lumen tube, and movement of the head and neck while the patient is intubated [2,3]. A higher incidence is observed in patients who have a chronic use of steroids, are of advanced age, are female [4] and/or have other inflammatory lesions of the trachea. The common symptoms of postintubation tracheal laceration are chest discomfort, dyspnea, dysphonia, cough, hemoptysis, mediastinal emphysema, subcutaneous emphysema, and pneumothorax. The tracheal laceration is detected early when the laceration Tracheal Laceration Related to Endotracheal Intubation