A case of laryngeal stenosis in the adult, successfully treated by intubation : continuous wearing of tube for four years / by William K. Simpson.

  • Simpson, William K.
Date:
1909
Catalogue details

Licence: In copyright

Credit: A case of laryngeal stenosis in the adult, successfully treated by intubation : continuous wearing of tube for four years / by William K. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    was very evident that the intubation tube had ex- erted considerable pressure absorption. The patient was very apprehensive and nervous about being without the tube, which I think might have been a factor in bringing on the suffocative attacks at this time. The tracheal fistula had been kept open since the beginning, but it was now decided to close it, which was done under chloroform on July ist, 1903, by Dr. Forbes Hawkes at the Presbyterian Hospital, the edges being excised and brought together by sutures; this is the first instance of which I know of a patient going under a general anesthetic, breathing entirely through an intubation tube; the operation was performed apparently as well as if she had been breathing through a normal larynx. The operation resulted in a permanent closure of the tracheal wound. The intubation tube was worn from June 24th, 1903, till May 23rd, 1905, when it was coughed out, but was replaced in a few hours, as the patient did not wish to take any chances in being without it. During this long period the patient was perfectly comfortable'as far as her breathing was concerned, and did her ordinary work, and traveled consider- able distances throughout the country. Occasionally during attacks of coughing the tube would become partially expelled, but she had learned the art of pushing the tube back in place with her finger and exerting pressure, until the attacks would cease. She could eat and drink with comparative comfort and her general condition became much improved, it being in marked contrast to the period in which she was wearing the tracheotomy tube. She often ex- pressed herself that it would have been impossible for her to have lived under the severe physical strain of the tracheal cannula. She was often asked to have the intubation tube removed, but refused, stat- ing that she was perfectly satisfied with her condi- tion. However, on April 23rd, 1907, as the tube was becoming somewhat foul from secretion, and be- coming convinced of the necessity of trying to do without it, she consented to its removal, which was