Discussion
Tracheostomy related tracheal tear occurs infrequently and less commonly
than intubation related tracheal tear. Mostly it is related to
tracheostomy placement, using cuffed tubes and overinflation of the cuff
or the tear directly follows traumatizing tracheostomy tube introducer
insertion. The tear due to tracheostomy mostly located proximal to
carina and distal to insertion of point of tracheostomy. Symptoms and
complications of the tear may occur intraopertivly or
postoperatively(5). Gold standard method for diagnosis will be
established by flexible or rigid tracheobronchoscopy which helps in
determining the site, size, extension of the tear and its location with
respect to the carina that are essential to document. Imaging studies
like CT scan which also helps in establishing the diagnosis of tear and
some of it is complications such as pneumothorax, pneumonia,
pneumomediastinum and mediastinitis. Treatment can be conservative for
small uncomplicated wound in stable patient. For larger complicated
tears and unstable patient surgical treatment is the gold standard.