抄録
A 69 year-old male, driving a car, swerved and collided into a tree. He was sent to our hospital because of dyspea with extension of the neck. Although he had no subcutaneous emphysema nor open wound, he showed bilateral pneumothorax. Thoracic drainage was performed and his dyspnea improved. One day after admission his dyspnea recurred without emphysema. We tried tracheostomy because of bilateral recurrent nerve paresis. The cervical trachea was completely separated between the cricoid cartilage and the 1st tracheal ring. Under general anesthesia, tracheostomy was performed at the level of 3 rings distal from the separated part and tracheoplasty was carried out. Ten days after the operation, progressive necrosis occurred in the anterior wall of the trachea between the anastomosis and the tracheostomy. A silicon T-tube was inserted to keep the tracheal lumen open 50 days after the operation. The proximal end of the T-tube did not pass the vocal cord because slight movement of vocal cord appeared. Granulation tissue gradually replaced the necrotic tissue. After the silicon T-tube was removed 78 days after the operation, the T-tube wound was closed, then he was discharged with horseness but without dyspnea.
