Clin Exp Otorhinolaryngol.  2011 Jun;4(2):105-108.

Post-Intubation Tracheoesophageal Fistula with Posterior Glottic Web

• Lee JE
• Chang MY
• Kim KH
• Jung YH

Abstract

Tracheoesophageal fistula (TEF) after prolonged intubation could present as chronic aspiration and could be mistaken as unilateral or bilateral vocal fold palsy, especially when there was combined posterior glottic synechia. We present a case of post-intubation TEF which was successfully treated with tracheal resection and anastomosis with primary esophageal closure. The accompanying posterior glottic web was treated by endoscopic technique of web lysis, with topical application of mitomycin C solution.

Keyword

Tracheoesophageal fistula; Laryngeal stenosis; Surgical anastomosis; Tracheal resection

MeSH Terms

Anastomosis, Surgical
Intubation
Laryngostenosis
Mitomycin
Tracheoesophageal Fistula
Vocal Cord Paralysis
Mitomycin

Figure

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  Fig. 1 Telescopic findings. (A) Posterior glottic web is found between the arytenoids (arrow). (B) Tracheoesophageal fistula is seen on the left posterior wall of the trachea, 1 cm above the level of tracheostoma (arrowhead).

• 

  Fig. 2 Operative findings. (A) Division between the trachea and the esophagus. (B) Slit-like esophageal fistula is found after tracheal resection (arrow).

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  Fig. 3 Telescopic findings on follow-up visit. (A) Normal vocal fold movement and no posterior glottic web. (B) Complete approximation of vocal folds on phonation.

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