MANAGEMENT OF SUPRASTOMAL COLLAPSE скачать в хорошем качестве

MANAGEMENT OF SUPRASTOMAL COLLAPSE

Introduction 1. Explanation of Suprastomal Collapse • Define suprastomal collapse as a condition above the tracheostomy stoma involving the weakening of the anterior tracheal wall, leading to airway narrowing. • Distinguish it from suprastomal granulation tissue, though both can coexist. Pathophysiology and Risks 2. Causes and Mechanisms • Though not fully understood, explain how the collapse occurs due to softening of the tracheal wall near the stoma, causing it to prolapse into the airway and limit airflow. • Discuss complications, such as increased risk during decannulation and possible need for re-cannulation due to airway blockage. Diagnosis and Assessment 3. Visual Assessment and Endoscopic Diagnosis • Emphasize the importance of endoscopy to observe the prolapsed section and gauge the extent of obstruction. • Reference the attached image as an example of the collapse, illustrating the narrowing in the subglottic area. Management and Treatment Options 4. Management of Minor Collapse • Explain that minor collapse often resolves after decannulation without further intervention. 5. Surgical Treatments for Severe Cases • Describe surgical options, including excision and transfixion of the collapsed segment, sometimes supported by short-term endotracheal intubation to maintain healing. 6. Advanced Techniques for Stability • For moderate cases, surgeons may elevate the collapsed section using sutures around cartilage and strap muscles. • In severe cases, cartilage grafts may be added for reinforcement, and techniques such as KTP laser ablation can help remove obstructive tissue. Added Insights from ENT Surgery Lectures by Dr. Sunil Kumar Sharma 7. Dr. Sunil Kumar Sharma’s Insight • Summarize key takeaways shared by Dr. Sunil Kumar Sharma in his ENT surgery lectures, emphasizing his approach to suprastomal collapse management and the importance of tailored surgical intervention based on patient needs. • Mention any unique techniques or strategies highlighted in his lectures, such as specific suturing approaches or post-operative care. #nose #throathealth #ear