Resection of stenotic trachea: a case presentation

Tracheal stenosis is usually a complication of prolonged mechanical ventilation. If the narrowing is severe it will greatly obstruct the air flow. Resection of the damaged trachea is a life saving procedure. The anesthetic management of the resection of an "ice cream cone narrowing" of the trachea (3 mm diameter) 4 cm above the carina is reported. A forced vital capacity loop (expiration-inspiration) of air flow versus volume revealed preoperatively little difference in the flow during the forced (F-V) and resting ventilation (Vt), thus confirming a diagnosis of severe upper airway obstruction. A total obstruction of the air flow was encountered during the skeletonization of the trachea and the surgeon was allowed to work for not more than 60 seconds at a time. Perfect cooperation between the surgeon and the anesthetsia team is necessary for the successful completion of this type of surgery.