Τρίτη 20 Ιουλίου 2021

Airway Management of the Deformed Trachea Using T-Tube Stents in Patients with Mucopolysaccharidosis Type IVA

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Ann Otol Rhinol Laryngol. 2021 Jul 20:34894211032778. doi: 10.1177/00034894211032778. Online ahead of print.

ABSTRACT

INTRODUCTION: Mucopolysaccharidosis (MPS) type IVA usually results in airway obstruction due to thoracic cage deformity and crowding of intrathoracic structures, causing tracheal compression by the tortuous innominate artery.

OBJECTIVES: To offer an alternative and effective method in dealing with the challenged deformity of the airway in patients with M PS type IVA.

METHODS: We present 3 patients with MPS type IVA who underwent airway stenting using Montgomery® T-tube stents. Three-dimensional reconstructed computed tomography was essential to design the T-tube and evaluate the anatomical relationship between the innominate artery and the trachea. The Y-shaped Montgomery® Pediatric Safe-T-Tube™ is more suitable for MPS type IVA. Regular follow-ups using fiberoptic bronchoscopy are necessary to evaluate the complications.

RESULTS: All 3 patients had good outcomes during the follow-ups until present, despite the complication of granulation formation, which was resolved by revising the limbs of the T-tube.

CONCLUSIONS: T-tube stents placed below the vocal cord may restore airway patency and preserve laryngeal function, including respiration, phonation, and swallowing, in patients with MPS type IVA.

PMID:34282634 | DOI:10.1177/00034894211032778

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