永久気管孔内部の気管粘膜炎に対してグリセリン加ネブライザー療法が有効であった1症例

Glycerol added nebulizer therapy for tracheal mucositis inside permanent tracheal fenestra after pharyngolaryngoesopagectomy：A case report

はじめに

　下咽頭癌や食道癌に対する咽喉食摘術後や喉頭全摘術後の永久気管孔内部の気管粘膜は，炎症をきたして痂疲が多量に付着し，術後の気道管理の妨げとなることをしばしば経験する^1,2）。今回われわれは下咽頭癌に対して咽喉食摘術を施行し，永久気管孔内部に急性気管粘膜炎をきたして多量の痂疲が付着し，当初治療に難渋したが，グリセリン加ネブライザー療法を施行して軽快した1症例を経験したので報告する。

　A 63-year-old male with hypopharyngeal carcinoma（T3N2bM0, Stage Ⅳa）received 5-fluorouracil＋nedaplatin therapy and underwent pharyngolaryngoesopagectomy with bilateral neck dissection and free jejunum transplantation. Postoperatively, he suffered tracheal mucositis and repeated massive crusts formation inside the permanent tracheal fenestra, causing dyspnea. On the postoperative day 29, we started glycerol added nebulizer and spray atomization. On the day 4 of the nebulizer therapy, we withdrawed aspirin and cilostazol. On the day 6, these crusts were almost vanished. In conclusion, adequate moisturization such as glycerol added nebulizer and the withdrawal of antiplatelet drugs when persistent tracheal mucositis and crusts were most helpful.