Ｐｏｓｔ‐ｔｒａｃｈｅｏｓｔｏｍｙ　Ｌｅｓｉｏｎｓに関する形態学的研究

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タイトル別名
  • A Morphological Study of Post-tracheostomy Lesions
  • Post tracheotomy Lesions ニ カンスル ケイタイガクテ

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説明

The recent broadening in indications for tracheostomies suggests that the incidence of posttracheostomy lesions will increase. Yet to date studies concerning post-tracheostomy lesions are rare in Japan.<br>The author studied post-tracheostomy lesions both macroscopically and microscopically in 32 tracheas removed at autopsy, 22 males and 10 females, with ages ranging from 4 months to 87 years. Sites of tracheal wall injury of all specimens were examined macroscopically and 12 specimens were further rated according to Grillo's rating scale prior to formaldehyde fixation. Lesions from high incidence sites of each specimen were taken for microscopic study.<br>The purpose of the study was to confirm the sites with high incidence of damage to the tracheal wall and the degree of damage. These microscopic findings were used to assess the appropriateness of Grillo's rating scale.<br>It has been stated that the three major sites where post-tracheotomy lesions occur are the stoma, cuff, and tip sites (Stiles, 1965; McCullough, 1976). Similar results were obtained in this study, although the incidence and degree of damage at the tracheostoma were greater than previously reported.<br>Macroscopic findings (Grillo's rating) and microscopic findings of the 12 specimens were compared. The author found a discrepancy between these two findings in the mildly damaged areas. In cases of moderate to severe damage, however, the findings were in agreement.<br>The author further notes that many clinical factors may affect the occurrence and degree of post-tracheostomy lesions. Such factors include general patient condition which may affect tissue resistance, technique, type of incision, duration of tracheostomy, material, shape and angulation of tube, cuff pressure, use of respirator, and so on. To avoid damage to the trachea, such factors must be considered.

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