Tracheoesophageal fistula after dilation of a subglottic stenosis.A white, 63-year-old man came to our clinic 3 days after undergoing an endoscopic C[O.sub.2] laser radial incision and dilation of a 90% subglottic stenosis. The patient complained of aerophagia aerophagia /aero·pha·gia/ (-fa´jah) excessive swallowing of air, usually an unconscious process associated with anxiety. aer·o·pha·gia or aer·oph·a·gy n. and excessive eructation eructation /eruc·ta·tion/ (e?ruk-ta´shun) belching; casting up wind from the stomach through the mouth. e·ruc·ta·tion n. The act or an instance of belching. . The patient was febrile (101.7[degrees]F) and had physical and radiologic evidence of pneumonia. The results of a barium swallow examination were normal. Because of the high index of suspicion for tracheoesophageal fistula (TEF), transnasal esophagoscopy was performed in the clinic. Esophagoscopy revealed the presence of a 4 x 6-mm fistula on the anterolateral anterolateral /an·tero·lat·er·al/ (an?ter-o-lat´er-al) situated anteriorly and to one side. an·ter·o·lat·er·al adj. In front and away from the middle line. wall of the esophagus (figure, A). The TEF was also visible on tracheoscopy tracheoscopy /tra·che·os·co·py/ (-os´kah-pe) inspection of interior of the trachea.tracheoscop´ic tra·che·os·co·py n. Examination of the interior of the trachea, as with a laryngoscope. (figure, B). [FIGURE OMITTED] From the Center for Voice Disorders, Department of Otolaryngology, Wake Forest University Medical Center, Winston-Salem, N.C.; www.thevoicecenter.org. |
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