CONCLUSIONS: Prolonged artificial pulmonary ventilation by tracheostomy tube (>30 days) doubled the risk of stenosis (relative risk, RR = 2.04, p = 0.002). Critically ill patients with repeated tracheotomies were more than six times likely to experience stenosis (RR = 6.44, p< 0.001) than other critically ill patients. OBJECTIVE: In this retrospective study, we describe the occurrence of laryngotracheal stenosis (LTS) in critically ill patients after elective tracheostomy who had undergone treatment for LTS at the Na Homolce Hospital in Prague, Czech Republic. METHODS: We studied 28 patients who were diagnosed with symptomatic LTS. Basic major demographic data, duration of mechanical ventilation, onset of tracheal stenosis after decannulation, and tracheostomy type (percutaneous dilatational or surgical tracheostomy) were recorded. The number of patients requiring repeated tracheostomies was also recorded. RESULTS: Neither the demographic data nor the type of tracheostomy represented statistically significant risk factors. The risk factors for LTS were prolonged artificial pulmonary ventilation using the tracheostomy tube (p = 0.005) and repeated tracheostomy (p< 0.001). The mean onset of stenosis symptoms was 53.7 days (range 2-300 days), with a median of 58 days. Stenosis involved the trachea in 20 patients, subglottis in five cases, and glottis and subglottis in three cases. Seven patients (25%) underwent a tracheal resection and primary end-to-end reconstruction. One patient underwent laryngotracheoplasty with dilatation. The procedure was endoscopic in 18 patients (64.3%). Two patients (7.1%) received permanent tracheostomies.

• MeSH
• bronchoskopie MeSH
• jednotky intenzivní péče MeSH
• kritický stav MeSH
• laryngostenóza etiologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• odpojení od ventilátoru MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• stenóza průdušnice etiologie   chirurgie   MeSH
• tracheostomie škodlivé účinky   metody   MeSH
• umělé dýchání škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Many different surgical and nonsurgical techniques have been used to treat patients with chronic recurrent temporomandibular joint (TMJ) dislocation. The nonsurgical techniques consist of injecting different substances into the TMJ area. This study was carried out to assess autologous blood injection to the TMJ for treatment of chronic recurrent TMJ dislocation. PATIENTS AND METHODS: Thirty patients having chronic recurrent TMJ dislocation were randomly divided into 2 equal groups (15 patients in each). Group A was treated only by autologous blood injection into the superior joint space (SJS), whereas group B received autologous blood injections to the SJS and the pericapsular tissues (PT). RESULTS: At the end of the follow-up period of 1 year, the results of the current study have showed that injection of autologous blood to the SJS and PT gave a higher success rate (80%) than its injection only into the SJS (60%). Moreover, the patients of group B had an average decrease in their maximal mouth opening (5.3 +/- 2.1) higher than that of group A (3.6 +/- 1.5). Also, the digital radiographic imaging of the joints in group B only showed the condylar head posterior to the articular eminence, in open position, instead of being anterior to it before the injection. In both groups, no destructive changes to the bony components of the joint have been observed. CONCLUSIONS: We could conclude from this study that the injection of autologous blood into the TMJ in patients with chronic recurrent dislocation is a simple, safe and cost-effective technique. So, we encourage injection of autologous blood to the SJS and PT for treatment of patients with chronic recurrent TMJ dislocation, as it has shown better clinical and radiographic results than its injection only to the SJS.

• MeSH
• autologní krevní transfuze MeSH
• chronická nemoc MeSH
• dislokace kloubu terapie   MeSH
• dospělí MeSH
• injekce intraartikulární MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• následné studie MeSH
• nemoci temporomandibulárního kloubu rehabilitace   terapie   MeSH
• nestabilita kloubu terapie   MeSH
• recidiva MeSH
• rozsah kloubních pohybů MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH