Congenital Tracheomalacia Associated with Esophageal Atresia

(1)

161

Vol. 8. No.2, December 2002

Congenital Tracheomalacia Associated with Esophageal Atresia

Seok Joo Han, M.D., Eun-Joo Jung, M.D., Se-Heon Kim M.D.,!

Choon Sik Yoon, M.D.,2 Kyu-Dae Shim M.D.,3 Yong Taek Nam M.D.,3 Jai-Eok Kim, M.D.,4 Eui Ho Hwang, M.D.

Department of Surgery, Department of Otolaryngolog/, Department of Radiolog/, Department of Anesthesiolog/, Yonsei University College of Medicine and

Department of Pediatric Surgery, Sowha Children's Hospitaf Seoul, Korea

This is a case of tracheomalacia associated with esophageal atresia, An ll-month-old- male boy presented with a life-threatening apneic spell after correction of esophageal atresia (Gross type C), After complete exclusion of the other possible causes of the apneic spell, the presumptive diagnosis of tracheomalacia was made with fluoroscopy and 3-dimensional chest CT. The final diagnosis was made with rigid bronchoscopy under spontaneous respiration.

The aortopexy was performed with intraoperative bronchoscopic examination. The posto- perative period was unremarkably uneventful. The patient was discharged 9 days after the aortopexy and has remained well to date (5 months after the aortopexy).

(J

Kor Assoc Pecliatr Surg 8(2):161

~

165), 2002,

Index Words: Tracheormlacia, Esopmgeal Atresia, Aortopexy

~~P'a 71B-'i1:Q:}(tracheomalacia)~ 71B-'i1~Q] ~~P'a

Q}

:Q:}£ <j-o}oj

71B-l1j1:i:R~ ~~51';::: ~%~£ ~~Fa ~S.l1j1:i:R

(esophageal atresia)9} 'i1B-s:1oj A}T

~",~-o}~ 3i~5'.. ~2;j A~ l / - A - ' " I , 010n-l 15

o1.s. =7

^'2. 1 - ^JI...x.. ^;=> -olo~ ~:'>--ol"" l-1~ J.~7.·V,1

r

1 1-'

r ...

l ~L.:. 1-:.1-:.0 /-11;: r---'-

Correspondence :

Seok

100

Han, M.D., Department of Surgery, Yonsei University College of Medicine, Shinchon-dong 132, Seodaimoon-ku, Seoul 120-752, Korea,

Tel; 02) 3497-3375, Fax ; 02) 3462-5994, E-mail; sjhan@ywnc.yonseLac.kr

-'=-%A1

~J-711

;1:Jg

3i~5'.. "'~zj--'8q,

.::u1Y-

~

'i1TA}7}

~<j~ J:l}£~ ~~P'a ~S.l1j1:i:l19}

B-i(!-oH

~"'~~ ~~"'a

71B-'i1:Q:}011

t11~ .;;-~

li.Jl';::: *o}

~

'T ijjS},q.

01011

~ 'i1TA}~

Jo1-2-

~~~ ~ ~Fa ~S.l1j1:i:l19} %~s:1

oj

~"'~~ ~<'§:3j<j 71B-'i1:Q:}~

li.Jl-o}1i'1J.i 71B-'i1:Q:}011 t11-o}

oj

~

-o}oj li.JlA}

~ L},

~ 2~1

1l7R-~

'B'

^O

}7}

77R-~ ~1f-Si

J.1zj--'8 'TiT- s.%-Q] Zl-il;l,:3j

<j -B-"'a

.-2:.-g~ii'!j1} ;<a~%-Q]

-%i<jg *71 -'fj-o}oj

E}

llJ-%i011

J.i

~S.3':°8~% J.1i5~-o}g

%-

.-2:.%~ii'!01 ~",~-oH {ll1jB'A~

(2)

162

Fig. 1. The esophagography is showing no stricture of the esophageal anastomosis and recurrent tracheoesophageal fistula. Note the tracheal air shadow. The tracheal air shadow disappears in a region (black arrows) as the tracheal collapse during expiration.

% 2,900 g.2..5-

A~1QJ~.7B~5-

El1oj;t.2..u:j

A]~ A~1 2~011 ~

~Fa ~xlFj1S:B

(Gross type C)5-

Jl!.Aa4-~

(total correction)

~,<:. ~01 ~Jq. ~-%l ~},1 ~aZl/'J ~71},1 ~~g

(expira- tory stridor)jL}

Jf-~

-§-Jf-011

4-~

-§-El

~1011 °1~~ ~;+"J q~

°VJ

~Z1'<:' ~Sj.q.

<iJ-%l

~

}'1

i;~~ ~x3':°8~01Vl ~:3fJf-L} 71t}~xif-~

t}~Sl~1 ~-&-~)-.2..L} ~~Jf- ~1l

71t}.9.j lf17cl 01

~71

(expi- ration) }'1

~0}~1.c ~AJ01 t}~~Sj.q

C:J..'B 1). 24}'1Zl-

~

x

pH~Aa ~},}

(24 hours esophageal pH monitoring)01Vl

<?4*~14-

(reflux index)7} 4%5- .9.ju1

~J.c .<f1~x<?4*.c ~

*ElB%~oa.9.j 3~}-%l

TAa (three dimensional reconstruc- tion of the chest CT)011},l

rB~t}.9.j

71tJcl,<:.

t}~~~1 ~-&-9)

.2.. L} 1f-

~

% 0j 71 }, 1 Jf- (origin of innominate artery) 7} W%

i'l

~Z1g

.!!01tEAl

~1l

Jf--'F1£

4-~~.c

71t}.9.j W%

~Z1

01 %},1011

t}~~Sj.q

(J'B 2).

A}~ ~-i°1 9J~ ~<Jp}~

AJEl101Vl

},1i;~~

7J},a

71t}~17cl

(rigid bronchoscopy)

~A}AJ 71t}~~1

(carina)5-Jf-El

~

l.5cm AJlclJ011 Al

~71

}'1

~~

Z1

7cl 01

4~-o}.c ~~

71t}W%01

t}~~ojAl 71t}<?1§t~ ~Zl

W 4- 9JSj.q (J'B 3-A).

~o}.c

7J

^A

a

71t}~17cl ~A} ~~

~~ ~~Z1-

(apneic speU) 01

~;']-o}9tJl Jj1~ ~*~oj

%

~~}~5- ~~

SlSj.q. 71t}<?1§t£

~~ ~~ ~~Z1-9-1 ~%

ZlB -o}011

71t}~17cl ~A} ~ A~1 2~

(<iJ-'fi

A~1 13~)011

rB%

PJjJI.Aa~

(aortopexy)g

},1i;~ ~9)-q. 4-~

%

71t}~17cl

g %

Fig. 2.

A;

The left posterior oblique view of great vessels and heart in preoperative 3-D reconstruction of chest CT scan is showing an indentation (black arrow) of the innominate artery that was made by compression of the trachea.

S; The superior right anterior view of trachea, esophagus and lung in preoperative 3-D reconstruction of chest CT scan is showing a depression (white large arrow) of the trachea that would be made by innominate artery and the esophageal anastomosis site (white small arrow). C; The left anterior oblique view of trachea, esophagus and lung in postoperative 3-D reconstruction of chest CT scan is showing no depression (white large arrow) of the trachea but showing the persistent existence of the esophageal anastomosis site (white small arrow).

Abbreviations: Ao; aortic arch, RL; right lung, LL; left lung, Es; esophagus, Tr; trachea

(3)

163

Fig. 3. The bronchoscopic view of the trachea in spontaneous breathing. A; Before aortopexy, Note elliptical narrowed lumen and bulging of elongated membranous trachea posteriorly. B; After aortopexy. The tracheal lumen is now wider during all phase of respiration.

A1011

AliiE"8"}~~~9 71-tl-Al;;~jAJ

71-tl-W%01

~%~JI.;Aa~

Al iiE -f011

~{J~

g

~~"8"}~~q (J~

3-B).

%o}~ 4-~ ~Al 4-~ ~ ~~1i2

§71

^~:3fg~

r:l °l A J

^~~Al

?i711

~l~q.

4-~

-f

A~l 6~011 3~}.!f:!

-f-¥-

7aifE1B%~oa~5'- ~~~ ~

iL}

4-~ ~ ~011i2 71-tl-~ W%-¥-~7} ~~1~gol ~~s:1~

q

(J~

3-C).

%o}~ 4-~ A~l 9~ (~.!f:! A~l 22~)011

£1.!f:!"8"}

Oi

~A~ 4-~

-f 57B-%l5'-

3}jl~olY- ~~ ~~~ ~01

J,eVJ"8"}

JI.

^~Jq.

71-tl-~:&~

Jd.{Fa

~.£3}j15:11S4-

A}2f:

%~"8"}~ ~%~5'

w~Ai ~J~9 Jd.~-Vj ~.£3}j15:11

%A}sl Q.{ 37 %-68 %011 A l

%~~q

JI.

~q6, 7. {JA1~~ ~ Al1~ ;Aa.£~ ~}01~ ~J~y

Jd.{Fj ~.£3}j15:11 ~A}011Ai

51--'T-

-tl-~s:171.£ ~q JI..£ "8"}~8

Jd.~-Vj ~.£3}j15:11s1 ~lli011 ~{J°l

s:1JI.

~J~ ~0}~J1} ~A}

~011711~

01

~~ ~JlJ,jg

7J::1::"8"}Al ?ig 4-

^~r-}.

~ ~TA}7}

Jd.{Fj

~.£3}j15:11;; 4-~"8"}71 Al~~

3:.71011

~.£3}j15:11 4-~

-f

~ ~A~l ~01

£1.!f:!"8"}oi 1} A}c}1i2 %A}7}

4-

^7~%l

-f

~A}71 A}DJ~

18Jf-7}

^~J~q.

A}DJ egAl

AJ~J1}

71-tl-~:&~ ~7cJ~~ %7~ %g~~S4- Bl~~

71{J (seal bark cough)ol

~J~q~

13,

J~JI. q~ A}DJ.!f:!~~ ~~g

g

%~"8"}Oi ~

u]1, Jd.{Fj

~.£~15:11S4- %~~ 71-tl-~:&~

:Q J1} "8"}Oi

^A~

Zl

^~^{~ ~}^~^~(apneic

spell) ° 1 A} DJ.!f:!

^~

01 c} JI.

J-~Zf~q. J

-f011.£

Jd.:~:Vj ~.£3}j15:11S4- %~~ 71-tl-~:&7}

~

{J s:1

~

%A};;

~lli "8"}~

III

~J ~

Ai 18

~

J1} Al

~ ~ -¥-~ ~5'

~"8"}oi

-tl-'C! EtiL}011 %A};;

~~"8"}Oi 01~ -oW~"8"}JI.A} "8"}~~

~q.

JL1Y- -tl-'C! EtJ1} 9i Al

Aa~~ ~BJ1} ~lli BJ~

g ll1

~Al

*"8"} JI.

%A}~ ~~

71-tl-

~.7~~

(tracheostomy) g

~

JI.01=

p}~ ~

g 4-

~}i'il ~o}~q. J

-f 01

~011 ~~ Al~

J1}

^18~01

,*°lJiI1Ai 01

^~%~

EtJ1}011

~~~ ~%01 O}~JI.

~0}~J1} ~A}7} 2f:~01 s:1~ r-}f~°1=

W

~%01C}~ ~~

g ll1

^~

711 s:1

^~

q.

o}~

J

.!f:!~~ ~{i5iA1Al ?i~JAllil- 71-tl-~:&~ ~~~~

~Al1~ ~-¥--1f:- J-~-f 2-37~%l7J}::z1~ ~01::z1

?iq7} J -f011 Y-EtY-711 ~q9. Jd.~J,j ~.£3}j15:11~ qf~ ~0}5>1J1} ~A}011

71Vi~ 71-tl-~:& ~Al1~ Al~~~ ~AJ

(delayed manifes- tation of symptoms) 011 :;"8"1

2f:~;;

Jl"8"}Oi 01=

~q. ~

Jd.

~

J,j

~.£3}j15:11

%::Z}7} £1.!f:!"8"}711

~1JiI1 ~§A}011711 71-tl-~:&~

~Al1~

%71A171JI.

~C1lO1Vi

01;;

2f:~ ~711 -tl-~"8"}~ ~01

~

Jl"8"}q.

7-~~ 51--§ 71-tl-~:&011Ai~ ;Aa.£~ ~}01~ ~J~y

~2f:Q{~~

'5-tl-Q{71

~~

(brassy cough)

EE~ %7~%g ~

~(seal

bark)

%~5'- R~s:1~ ~~~~ 71{J~~y- %%~

~~ ~g

4-

~Jq. ~d~

g "8"}JiI1 §71

~r§%g ~d~~

4-

~J~ 18Jf-7} ~ql. 0litl ~%~ §71 Al -f~ll1'iJ- (intrath- oracic pressure) 01

~7}"8"}JI.

015'-

~"8"}Oi Q.{~ ~~g 7}~

71-tl-ll11801

~0}Al711

s:1JI.

~o}~ -¥-~~ HB}AiY-7}~ .:g-71~

B*5'-

~"8"}Oi ~J,j~r-}. ~-1f:--1f:-~ ~A}~ ~01Vi <{!B-~ ~

~ ~ ~

§ -g

~% ~

011

^q~

:;

^~^~

§ -g 71

^~Al1;;

Y-Etll1::z1

~i"~q. 71-tl-~:&~

Pl1

°1-f011~ ~-¥--1f:- ~A117} A}c}Al~

(4)

Tl

1':lCl~ti'{y {iliY~

{L(%C(il 11002 CCfYlioiloTG co'.fit [;'-c7

2-0-'V-Th. y

ty-~ O{:J.{2

-[i!:%t.J 1-0

R·~* Fo-t~·~~-

121Jl [10

%-g-~

r %lo

·!.l-l::lts{-'?-~Tt ~-l~r6{b {L-tjI~- {L(% LS)

[to LG

fylio~~dr~n*ll) w~"IY

fyllollolS fgFhl':IL i1{it* {ollf llf3p

~yt~i-Y

:J(2Hin f, ldTIH tlt9

-LI{~'65t2-o1lr lo~~

wliJ Ih'el':Ie;ly

fol~fgi'o

8"1'30

{ilfY~

p,1'I-[O -",'el':

IL:Oty

IM"{z~(%Zll

lloZ

lYinj~ ·j~w

Eh(6j'g lYisiV

y- IQlH<>

~(lOPU1S)

-:.H'?11

{ir~11c

{,ol<>b

~-lY~-

lollY

~4(%OZl

110, iu"-Yb{'l-ER

Ej~l<>b

"2-,,-kl,1lo 10R'j:

loliY~

IY.!z

[;'-~

CC(% 89) lloLl .)'do

·IJII~tbj?~dY ~-&1':

~it*Hl

Ilo1§FO{}[i loltoS'Z

-Th--~ll- ~-t~i: ~[6

loF2-f;!:

-lo~y

Ir£3p fyH ly t6[lo(;Z

-=-Q~--g- i~PDI ^·!.l~['01-I::l{b ~l:l~Tt

20 I>:

w~fo ~1i'j7 10~~dnn*liJ i1~@IY

kllofgFhl':IL i1l':

~ {o~YI[f3ty fyt~l-Y l~~

tlfo LIitt fzlb

2-0~i~l :J~

lol-;;::-fY

~--I.'Jl-Y{o

-fdL

IO~f)(~-~i:!'#HlJ ~z:1@ ~~ioFi ~~

lll'" 10 -g-l-z:

t6~--J7 ~-I:1'f¢{b iLIl-Y~ L -5{~loR-l -~ -1;-{~-{I\Y-

[y17

l~~

"hI!;

IO~%Fi lo~~ -~~Q-~ ~-=H6 lo~\I[iI IOFi-~'-iR

hkb

loj~{i\

c, ^ty ^j\': CClcs f1c1&

~-~l~Yhl?I: ·I~'\\\ I'd~

if]?,: IYJ{it jt,,!c

W~l~- 2,iI5~Y

1'15j"jo

{tlfy~

k

"fh{~·KfY

CC{eg,f,'rV

10"3:~ iH-~l

lostblcsJ"l"

fYlio~

"{:Ilo-i'flln ILb

~ ~

..

~

BolL

lIoIL~ ~1'l-c;..Ft

101,'-/'0

~'i,"ii-;c%i'i>{k

II 10 fy IIo{ejcQ{k II +zH

⁰ ^T:

N:"

Moj~

~l':

%l':IL

kllo~lFt

WI"loL

%~~

klfd;.: loj;.:t§

~{ef~

j"

~1{:jtlt?R~fy[IoM): ~b'i,~lt

t@ti;

:~HiB: 101"fQi,~IL

~RI~lo~-

fel2r lli1 IItlell, %lH" *1£

tol~·'" %~L H~IL jLjoL 11o~1In

Itlol1iY

I;:<~

[Ok&R>

+1.;:fQt,~IL

tJ-Z

~r)

-[:If.5[:i [0%3 lfiE ?i"2ofn-fFl

iOyfo ~-l-~:qo

i§

~-l~]:" ~~ 2-o-~z-f;-t-?lrt

-t

^~~

^lo.t2

-lo~Yllolto

it- Th

"£ '~;(l~Rt

[0%:'1 -F ltl

~{-'?-t<::~ ~-=L1"-fFl&~ {ol-5-~-&~

[0

-~~_

ltu

-&-~~dY %~f~~-hi:t:(fdlJ ~Ftf)C

Thlo

.(2: ~LHJ't'6Tb

::7

~-[O-tB -~-V ~-=i:-b~ls~ik {ot5-r~ %i~ loi,~l(

-V-hlyli lokn*fh-k

~fylloFtfh

.LJ (l-S

w~QIY

fyMio ?f

·(Y-Z

&

L)-blo·~~l

[LYb

lO[-{:i~ ~-=i:f6

::7 -m-TOi§ lfoly%

~--b-*

f¥

It(E\.g· IO(PSSdA

18dllilB:~II) tol~·-'"

§.LJ jSdljJ (l-[&

:E ·(8-(, tAL)

blo-8~n

lLfo ::7 -R lOi§

20-~ ~lY ~h5-

kWg,f,'r11

lli[:)c~

1':.\\\ I;.:';·

~-f'c-,\- ~ llilioVt~

loll: {iIlOc

1l""f2rIL

~{"

jop,j'l--j',

~I{:{tlt?j;: ~.LJ

jS84" U-S

~-lHo T:

·hle·lz

~Y 1':1~~ lo{l>~dY ~-(,LJ

lSJljJ a-s)

^fY~-

tid"

S lo?otr-?f\ fl-lt[,,-'\:-t 10{l-1i'1>:

i1~"1v

fyMio ?f j1j:I iHyly

1.\?~fL -~{8jcQj,W lotg:~z

h'fo

.{~t@ jOfo{~lI'ci7 §

-#-~:S:pl-6 l:o{-'?-&~

%HCI t63ty -P:lYV(,

~2o"3--l~

r

"([ tl>

L)

{:J lo-ifHn l/{ci

{Li-~ ~lb ~ -l~ -~-v

l:o{-?--&

~-fbiilY{- ~-

I>:

~I~;:t[g

lol':IL w!l:[o 11o-'\:-I'Q* Iv

IL~ ~H,~L ~b

{f{ejcQ{kll +zHo

^T:^.{~~

10 V

'H~{~j,~

l'l-iHx

^{:-WID]OJ

lfB ~lb ~--5-H)::

%-"[i!:[L

~-l.<£-* %v~pms ;)fdOJsolnlJ)

t?o-i§

[Y-ok K.ft [Y{.<£-lOi§

-~-~3ty ~-=i:klfot?o#3ty ·llt@

:\Oto-t

to!~·IZll~

k[0 §Io

tol~·[olo

fy[0

§-,h-to~yci-

lof.-B:IGly

j~loj~~ "'-li>-~

fo{.\?

:~'Ilo-li-:oty lUls[}lolfI8fQi,~IL

.p -1-2-0

%t6~~

ton;

^~

K',{3.-h

%l[-Y~- -l-2-~11-L 3%n(S!SOUJ1S

IU8l{JBJl JO PfOJf1J IBlfu8:a'uOJ)

-V(-~~ [-6{}[i -h[o~FO ~y-=g

bY

l-i ly

~ ~r 'u(S!SOUJlS TBJiml[dOSJ 11:?l~J.0uOJ) i~ ~ 3

ty fylHi ',rn(LUn]nJlj1dAlP ]BdlpBJj) rvli{l':IL 1i{1i·" {,fn:

. "'I'

1_ l-L-' 0 ^I

o-=-,

^0_ -.l1_L--rL ²^to:..lLV 0 i-S'-lY [_.I.- -, n '...1-1-' i"" I' I/--rL -:..l LV 'L __ R W f'i'- _LFlI'-r-l1.g.-u :-"-0 t§~ jg ~op,I'l-lt'tti

joll'Fhf2rlt ·{:Jlo!'L

~1.\?lfzIiLl

13fdlc % [Of/,

~j14~"l{'lI' ~Ify~ t@'7I~ ~I>:

t@<:r.£. PRk>-,h- k

lOb

llo{~

%f\R 16fgFhl':IL i1l':Fh

{oli~IIc·5IY

fylHi(

j~t@

HOR

^~oi'z~Y

~-fyc"c{iIH.g-

lo{eg,f,'rV

CClloi-~

loj>:ti:

CCj?·~ITP 'fl~

Ilo-f;!:Th i-

~~

H:;:[[E?-ity

~Yff~

2d--O-Y6 {i-6-Fz

~{~~YTh 3Ifo-=-~=-[2 (UO!:wqmXJ)

-V-{A

-=-~=- {;;:-~ K~lr£3p fYl-~lY -=-o~{'2-{A

y lyl'2 Thlo ·tJlol>:

~Io

1i{I'l-fnjy j1-olil 10*"- 10-,\:10 fyjiLlzjrut

lio~Y{~IY 20P{l;~,jl""T~ "fhld~"

HHY Thlo .{:Ii1

1i{1"~~~ *f~

.;r.j7

~llfl",

lQf2rIL

I'-I"jo],~ ~bfo

~l-l~~~ -~~~- 1D1~ ll(fot~ ~[i~ -[d~i: .-b~

LIk'{!?-

:~

~~-

lli{rf.Q. t-l % ;-lz:-m: -&-&:13

7!'lli~ %-t2K-£.-~

--[:lEe

1I(I/iC~ .~j?~ ~'j:

'4{;.:'W lUis IlrlYlo{.

^10~1I,

lotklt lin 10 ·!Cl!'c Iii

~

20

~

Ih

-§

(P.JljJBll JO UOljlocI SnOUp.lqWJLU) MiLf2rli lol"-.\:

~16

{Lj"F6f2rli jLCC;ty \015 llijz-

^L

dL 10 P"3- llo3ty IY

-g--~

·lJ:llb

1i:"l:~I~lR

lO-[7: {lI-3--[::l -=-o"'byfrt-i}

[-6-[[l~y{ft i~{fty lY~ {oJol~

+1t5

U{-l.<£-H2~ %-f>~ l~

lO

R~1lo j,fd~~,{Y

]itls

lli~- {tid~

lin 10

.{~!'c

llib'''': Iii

f'* {,Id,... P,1'\?'Rfli'S: fyj1I"fo'\

~

ILj;.:l!:

~{~t§

Iu-ob

101'l&4j,,~d"

11011,10 1'::0] fyllo1'::, Eldu

~*~

j,I-Llo

.,;-; JoL-J;-

-~-8 -1;-{~.fr\Y-

[yfl --[:1-& -5ld5

lli-l~·otA: lo~'~Y

Y"lln[}

^?;~

(UoqnqnluD 1,-PY {k[L*

-~--.Jo-t=%

[0 "bfo -[t.:--6-V

~l5

lli-6 10{'2-{AY pf2:

~1-8~l-6 ~-~l~Y ~2Un ~l:i

1[£-6-

IOt~~I[E lO~z-~it1 ~-6-FL

[-6{:qFO-B:lL

W[~ ~:1

%

tL~2L

·01hi'~ Iz{~·(fl~

{en"

{--doflC--[rrf-\V:

lOl~>2lz- ~k[lo{:gto-"[i!:[L ~f6 1~-l.<£-i8* %~

!h~

t9-tLf}

tnl~-~

-[1%{}- lY -!'"-f t

^Y

1?-bJ tdo%ll lov

1=\(;00(; ~ Zllt:: F,1, 8[l-<:: -h'[010Y 1'91

(5)

jti5}j7_

s~t~.Ly,

lfJ*'-}% i5}::Z]

~i5}o1 T~%

lit-f.-

7oj]oJ]J.l'f-~

50Ji (71 %)"iVl e:;"AI 'll:-tl°l lF€--oI9.l

^C

t_-,l -olnj 'ii:'Y"i'1i liJl 'll2-5'-

~]-ot"l

T{;---:lc "J-,"- 3oJI"IPK- 20Ji (67 %)"iI Al l'il'll 01

Vl~·slA] ~i-s:lcl-Jl .liJlo}~r}. I11*1!~JlAa~.g.

.liJtf

³

i_o_

.'L

44f

A~] 3~{}-&

o]-§-vl-

-tl-21:lJ-~-& 'l:o~ o]-§-~ljl ~.Q.

v1

^J ~-

ZFiL::z}

~)..]

0] uJ1j1j-g- A}{}-t}9Jr}.

rH%l211Jl78~~'

Ai"E 91 "Be 'I!'e'JI ll-tl"I:;J%

^7,{

01 Ai"E"'I'c

~

01 -tIl

_-:1

01%1": T'lcAtll 71'\'191 W-l'-!f-9i

\'L"I~

7ift:'I;;J_"-S'- zJ1l

-tl-~o]-1i1}.i r11*~~% jl)<a~ -~1 ~~ ~17;]Ql-

1:lJ"GJ% z-i

~-~

T S:U1 rfll-o]l=}.

[H*~~.llAa~ol 0]~Jl1

{:-.g.

{t4-~ }:;I_o]71~

c)"j-l..-t

~,!.~

JilAt"i1li1

^A

l JeW 5l,oc otL-lll

'=-~;I'c

*1 11 {l-'?I:<l:t9j

.If-~17l-

AJ-t:J-6] Zl

7J-~-on~ [H*1!~JlAa~~~ i'-A~]7l- .:Q:.~s1

;I§- JltB-ot11'c YJ,-"-ll °l'tl :;J-9-"iI'c '?Iiiol"1

~H'-~'$l

~. o]%~

7]¥l:-Q]

Ql1f-1f-~

(external

sDlint)~-

Jl2itH==-

~

01 "'rIIk-]')

_-0 _• _---'-7clcv'I_'~ _{1 _}_~I_{L .}

01

i'Jj5]- ""- ')oJ 1,---,- ..J_L.. "I '-I l-?~A-) 12 -I ")-til 0 l:J---'---'-0 " C

JPJoi '1i "1]0, '1J-'i-0I11":

7ift:'I;;J~- °l~:l--ofoj

Palmaz stent

%%

)*~c)"j-~ 1:lJl~f~T_ 7H~:rr1oJ

O]%:rrl.ll

9],rl-~).

~_~0i.2..~ ~-l~P'j 6J~z~ls~~- 7;L~B}j7_ S:H~ ~()}Qlj!l 2IAt%~ ~'iPd

-'-i"'-'91}IIS>t -li-'ii:5'loJ

'll:'~-ol-c

71-tl'?:!"t"il rN"1 * ^II {l-{l-:lc 7tAI-'l

'I'£'6j~1 ~~!%

-ot"1 0 r 1kl-'l

A~Zj-~cf.

1. Filler RM, FOite V:

Lesion

^(~l

the larYrL1: and trachea, in 0 .Neill Jr. JA. ROIve MI.

Gro,~feld

JL, Fonkalsrud RW, Coran AG (eds):

Pediatric Surgery (ed 5), chap 56.

St. Louis, Mosby-Year Book, 1998, Pp 865-868

2. Filston He, Shorter NA:

Esophageal atresia and tracheoesophageal ma(jormations, in Ashcraft KW (cd):

Pediatric Surgery (ed 3), chap 27, Philadelphia, WB Saunders, 2000, Pp 362-363

3. Beasley SW:

Esophageal atresia and tracheoesophageal fistula. in Oldham KT, Colombani PA!, Foglia RP (eds):

Surgc')! of Infants and Children (ed I), chap 61, Philadelphia, Lippincott-Raven, 1996,Pp 1026-1027 4. Benjamin B:

Ainvay obstruction, in Freeman

NT!;

Burge

D}vf, Crt/liths DJ;f, j\1alone PSJ (ed\):

Surgery of the Newborn (ed I), chap 31, New York, Churchill Livingstone, 1994, Pp 427-428

5. Kiely EM:

Aortopexy, in

Spitz L, Coran AG (eds):

Rob

&

Smith's Operative Surgery. Pediatric Surgery

(ed 5),

Chapman Hall, London, 6. Guy .1M, Triglia

1995, Pp 132-135 .1M, Louis C,

loG

Panuel M, CarcassonneM:

Rsophageal atresia. tracheomalacia and arterial compression: role of aortope.xy.

Em .I Pediatr Surg 1:261-265, 1991

7. Usui N, Kamata S. Ishikawa S, Sawai T, Okuyama H, Imura K, Okada A:

Anomalies of the tracheohronchial tree in patients lvith esophageal atresia.

.I Pediatr Surg 31:258-262, 1996

8. Beasley

S"'T,

Qi BQ:

Understanding tracheomalacia.

J Pacdiatr & Child H 34:209-210, 1998

9. Blair GK, Cohen R, Filler R:

Treatment of tracheomalacia:

eight years' experience .

.I Pediatr Surg 21:781-785, 1986 10. Kiely EM, Spitz L, Brereton R:

IVfanagement of trac-

heomalacia by aortopexy.

Pediatr Surg Int 2: 13-19, 1987 II. Bhatnagar V, Lal R, Agarwala S, Mitra OK:

Endoscopic treatment of tracheal diverticulum after primat'}' repair of esop/Ulgeal atresia and tracheuesophageal fistula.

J Pediatr Surg 33:1323-1324, 1998

12. Danis RK:

Tracheal diverticulum 'with recurrent apnea and segmental pulmonary ate/ectasis.

.I Pediatr Surg

17:182-183, 1982

13. Yeung CK, Spitz L, Brereton RJ, Kiely EM, Leake J:

Con~enital

stenosis due to tracheohronchial remnant: a rare hut important association with esophageal atresia.

J Pediatr Surg 27:852-855, 1992

14. Han SJ, Kim, Y, Kim M, Lee K, Han A, Hwang EH:

Slide cricotracheoplasty: A l'-lovel surgical technique fbI' congenital cricotracheal stenosis .

.I Pediatr Surg: 37:E36, 2002

15. Inoue K, Yanagihara J, Gno S, Kubota Y, Iwai N:

Utility of" helical CT fhr diagnosis and operative planning in tracheomalacia after repair of esophageal atresia.

Em .I Pediatr Surg 8:355-357, 1998

16. Benjamin B:

Tracheomalacia in infants and children.

Ann Olol Rhino Laryngol 93:438-442, 1984

17. Filler RM, Messino

1\

Vinograd I:

Severe tracheomalacia associated 'with esophageal atresia: result qf surgical treatment .

.I Pediatr Surg 27:1136-1141, 1992

18. Bianchi A, Greenhough SG: Repair of long-segment tracheomalacia with t1·ee autogenous cartilage ring graft.

Pediatr Surg Intern 7:236-242, 1992

19. Filler RM, Buck JR, Baboric A, Steward OJ:

Treatment of segmental tracheomalacia and bronchomalacia by imp- lantation of an ainvCD-'

~plint. J Pediatr Surg 17:597-603, 1982

20. Vinogad I, Filler RM, Bahoric A:

Long-term functional

results qf prosthetic ainvay splinting in tracheomalacia

and bronchomalacia. J

Pediatr Surg 22:38-41, 1987