Technique to Improve Tracheostomy Speaking Valve Tolerance after Head and Neck Free Flap Reconstruction
| Autor: | Keri M. Danziger, Jamie P. Levine, David L. Hirsch, John T. Stranix, Ginger Mars, Veturia L. Dumbrava |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
business.industry Pulmonary disease Case Report Anatomy Ventilator dependence Cancer resection Surgery 03 medical and health sciences 0302 clinical medicine Airway resistance 030228 respiratory system Tracheostomy speaking valve medicine Head and neck surgery Free flap reconstruction 030223 otorhinolaryngology Head and neck business |
| Zdroj: | Plastic and Reconstructive Surgery Global Open |
| ISSN: | 2169-7574 |
| DOI: | 10.1097/gox.0000000000001082 |
| Popis: | Summary: Increased upper airway resistance from postoperative changes after major head and neck surgery may cause elevated transtracheal pressures and result in tracheostomy speaking valve intolerance. This may be particularly true among patients with baseline pulmonary disease. We describe a patient recovering from oral cancer resection and flap reconstruction who demonstrated prolonged ventilator dependence and tracheostomy speaking valve intolerance with abnormal tracheal manometry. We attempted to improve speaking valve tolerance through the adaptation of a valve modification intended to reduce transtracheal pressures. Drilling holes into the 1-way speaking valve allowed for excess air egress and resulted in normalization of transtracheal pressures with improved speaking valve tolerance. This 1-way speaking valve modification may serve as a simple method to allow for earlier restoration of voicing and potentially reduce the number of ventilator- dependent days in this patient population. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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