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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    done, and up to the present time, May, 1908, there has been no occasion for its reintroduction. The condition of the tube was as follows: Some odor, owing to adherent secretion on its superior exposed portion, some small areas of very superficial erosions on external surface, principally on the pos- terior surface just above the swell, indicating the points of greatest pressure. Internally the tube was coated with fine calcareous deposits evenly dissemi- nated over its entire surface. Immediate examination of the larynx showed a pretty fair glottic space, larger than at the^time of last removal. The mucous membrane was very red in color, but no ulcerations; the motion of the larynx was good, excepting the left side which did not move as well as the right, the immobility seeming to be limited to dense tissue about the left arytenoid: both cordal areas seemed to move well, there was considerable general superficial swelling of the mu- cous membrane, breathing good, voice aphonic. The patient was somewhat apprehensive as to her ability to breathe without the tube; this wore away as soon as she regained her confidence,. The breathing has continued to improve and is normal in character. She has also gained decidedly in flesh and strength, and considers herself as well as ever. Her voice, though not normal, is variable as to strength and quality; at times being excellent, but becoming hoarse when taking cold, and in damp weather. Examination of larynx at the present time, May, 1908, one year and over since the final removal of the tube, shows the following: Color, normal, with tendency to paleness. Motion, somewhat restricted, due mostly to indu- ration about the left crico-arytenoid region, the right side moving with much less restriction. Right vocal cord is fairly normal in contour, color and motion. Left vocal cord seems to have been more or less absorbed. Right arytenoid, slightly enlarged, movable. Left arytenoid, considerably indurated ; the glottic space, though irregular in shape, is most ample in