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- Title
Tracheoesophageal Fistula as a Complication of Prolonged Ventilation in COVID-19: Description of Reconstruction and Review of the Literature.
- Authors
Walker, Kendra N.; Carlson, Kevin J.; Rubinstein, Benjamin J.; Sinacori, John T.; Mark, Jonathan R.
- Abstract
Infection with COVID-19 pneumonia may necessitate intubation and mechanical ventilation. Viral inflammation and pressure necrosis may lead to scarring, stenosis, and in severe cases, fistula formation. Nonmalignant tracheoesophageal fistulas (TEF) represent a surgical challenge and may necessitate locoregional tissue transfer and tracheal resection to prevent recurrence and maintain airway patency. We present a case of TEF in a 63-year-old female secondary to prolonged mechanical ventilation in the setting of COVID pneumonia, detailing the clinical findings and surgical repair. Primary closure of the esophageal defect with pectoralis major muscle flap onlay and tracheal resection, with median sternotomy for access, provided successful intervention, allowing for subsequent tracheostomy decannulation and return to a complete oral diet. This case offers further evidence of the increased risk of airway complications in COVID-19 infection and provides otolaryngologists with an example of a rare surgical approach useful in management.
- Subjects
ADULT respiratory distress syndrome treatment; TRACHEAL surgery; TRACHEOTOMY; MEDICAL specialties &; specialists; COMPUTED tomography; ENDOSCOPIC surgery; ARTIFICIAL respiration; PLASTIC surgery; COVID-19 pandemic; TRACHEAL fistula; ESOPHAGUS diseases; CRITICAL care medicine; COMORBIDITY; ENDOSCOPY
- Publication
ENT: Ear, Nose & Throat Journal, 2024, Vol 103, p120S
- ISSN
0145-5613
- Publication type
Article
- DOI
10.1177/01455613231189907