Surgical Resection of Acquired Vulvar Lymphangioma Circumscriptum

183 Im ages is large and deep. In these cases, it is usually detected intraoperatively. However, smaller tears are detected during the postoperative period. The exact site and size of the abovementioned laceration is determined by bronchoscopy; this knowledge helps in planning the therapeutic approach. Nonoperative indications are stable vital signs, no difficulty ventilating while intubated or respiratory distress while extubated, no evidence of esophageal injury, minimal mediastinal fluid collection, nonpro­ gressive pneumomediastinum or subcutaneous emphysema, and no signs of sepsis [5]. In our case, the tracheal laceration could have arisen after elective operation or uncomplicated intubation, as the patient had no underlying diseases. Her risk factors were only the head and neck surgery and her gender. These risk factors are common in patients who undergo operations in plastic surgery. We assume two possible causes in this case. First, potadine and bleeding could have irritated the trachea and triggered a cough and gag reflex. Secondly, repeated sterilization for reuse may have increased the stiffness of the intubation tube. A plastic surgeon must be familiar with the causes and the symptoms of tracheal laceration. In particular, such a laceration could have occurred during a short operation such as a closed reduction of the nasal bone. For the prevention of tracheal laceration, we need to determine a patient’s underlying disease. Further, plenty of irrigation is required for the removal of the potadine and blood before extubation.