Tracheal Ring Resection with Crico-Tracheal Anastomosis Under Endoscopic Assistance

The authors report a case of tracheal ring resection with crico-tracheal anastomosis performed under endoscopic assistance. In 2010, a 31-year-old Caucasian male was involved in a high-velocity motor vehicle accident. He experienced severe polytrauma and subarachnoid hemorrhage. A slow recovery was predicted, and a surgical tracheostomy was performed. The patient was then transferred to a rehab unit. In January 2011, the patient experienced an accidental extubation with respiratory arrest. A fiberoptic bronchoscopy was performed to assess patency of the upper airways. A tight subglottic stenosis secondary to granulation tissue was found. Rigid bronchoscopy was unable to restore airway patency. An endoscopically assisted tracheal ring resection with crico-tracheal anastomosis was performed, and airway patency was restored. Fiberoptic bronchoscopy played a pivotal role during diagnosis, and assisted the surgeon during resection and anastomosis.