BACKGROUND: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. METHODS: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications. RESULTS: Twenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2% (n = 18) and 0% (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy. CONCLUSIONS: Patients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.
Body Mass Index ; Humans ; Korea ; Medical Staff ; Mortality* ; Mouth Neoplasms ; Postoperative Period ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Tracheitis ; Tracheostomy

Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.
Aspergillus ; Autopsy ; Bronchi ; Bronchitis ; Cause of Death ; Fungi ; Humans ; Hyphae ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis ; Middle Aged ; Trachea ; Tracheitis ; Trees

Aspergillus infection localized to the tracheobronchial tree is an unusual form of invasive aspergillosis in which patients are usually immunocompromised. The infected airway may produce mucosal exudates and become obstructed partially or completely with fungal plugs and pseudomembranes. Microscopically, the superficial portion of the airway wall is acutely inflammed and invaded by fungal hyphae. We recently experienced a case of invasive aspergillus tracheobronchitis that occurred in a 43 year-old woman with acute lymphoblastic leukemia, for which she had received a 2nd consolidation chemotherapy. We report this case with a review of literatures.
Adult ; Airway Obstruction ; Aspergillosis* ; Aspergillus ; Bronchitis ; Consolidation Chemotherapy ; Exudates and Transudates ; Female ; Humans ; Hyphae ; Immunocompromised Host* ; Leukemia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Respiratory Insufficiency* ; Tracheitis

Vascular ring, originating from abnormal regression of the aortic arch during fetal life, can cause prolonged and recurrent respiratory symptoms and dysphagia when the diagnosis is delayed. We report a 4 month old girl with vascular ring, who had been treated for persistent respiratory symptoms including stridor, wheezing, and dyspnea soon after birth. Initially her respiratory symptoms were thought to be due to bronchiolitis, for which respiratory syncytial virus was confirmed by immunofluorescent staining. Her clinical course was again complicated with tracheitis and pneumonia due to Haemophilus influenzae type b. The possibility of anatomical anomaly was investigated when it was felt to be difficult to insert a suction catheter deep down through a endotracheal tube which was placed for adequate ventilatory management. A three-dimensional chest CT revealed a vascular ring consisting of a double aortic arch. For 5 months following surgery, her respiratory symptoms have slowly been improving. She developed another episode of pneumonia which was milder than the one which occurred before the surgery.
Aorta, Thoracic ; Bronchiolitis ; Catheters ; Deglutition Disorders ; Diagnosis ; Dyspnea ; Female ; Haemophilus influenzae type b ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Infant ; Parturition ; Pneumonia ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Suction ; Tomography, X-Ray Computed ; Tracheitis*

A 44-year-old Korean male died of rapidly progressive respiratory failure and refractory hypoxemia in 8 days after being admitted with a fever and dyspnea. The patient was diagnosed with pseudomembranous necrotizing tracheobronchial aspergillosis by fibroptic bronchoscopy and it was not related to an invasion of the pulmonary parenchyma. To the best of our knowledge, this case represents a patient with pseudomembranous necrotizing tracheobronchial aspergillosis that developed in an immunocompetent host, rapidly resulting in airway obstruction with acute respiratory failure and refractory hypoxemia without an invasion of the pulmonary parenchyma.
Tracheitis/complications/diagnosis/*immunology ; Tomography, X-Ray Computed ; Respiratory Insufficiency/diagnosis/etiology ; Necrosis/complications/diagnosis/immunology ; Male ; *Immunocompromised Host ; Humans ; Fatal Outcome ; Diagnosis, Differential ; Bronchoscopy ; Bronchitis/diagnosis/*immunology/radiography ; Biopsy ; Aspergillosis/complications/diagnosis/*immunology ; Adult