PMC3395408_01
(A) Chest X-ray upon admission. (B) Computed tomography scan of neck upon admission. (C) Computed tomography scan of neck post-laser intervention and systemic treatment. (D) Bronchoscopic findings demonstrating (web-like) fibrotic stenosis.
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A chest X-ray revealed blunting of the left costophrenic angle and evidence of tracheal stenosis (Figure 1A). The fiberoptic bronchoscope revealed a membranous web-like stenosis of the trachea (Figure 1D). Endoscopic treatment with laser incision and systematic steroid administration provided the solution (Figure 1C).
(A-C) Application of the Levin tube through the bronchoscope (steps). (D) Demonstration of the laryngeal mask with the bronchoscope and Levin tube. (E) Levin tube within the laryngeal steel handle mask. (F) Endotracheal tube with the Levin tube inserted as a guide.
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Therefore, a computed tomography scan of the thorax was performed and revealed narrowing of the trachea at the level of the thyroid gland (Figure 2B). A red stomach tube (Levin's type) of 18 (Fr/Ch) or 6.7 mm (size OD; Well Lead Medical Co) was firstly applied throughout the bronchoscope and was inserted into the laryngeal mask to be used as a guide for the endotracheal tube that we intended to use (Figures 2 and 3).
(A) Laryngeal steel handle mask. (B) Levin tube. (C) Ambu face mask. (D) Levin tube with the edges cut off. (E) Bronchoscope. (F) Endotracheal tube.
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A red stomach tube (Levin's type) of 18 (Fr/Ch) or 6.7 mm (size OD; Well Lead Medical Co) was firstly applied throughout the bronchoscope and was inserted into the laryngeal mask to be used as a guide for the endotracheal tube that we intended to use (Figures 2 and 3).
Evita 2 Dura (Drager, Medical GmbH, Lubeck, Germany).
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The patient was ventilated with an Evita 2 Dura ventilator (Drager Medical GmbH, Lubeck, Germany) (Figure 4).