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Nebulised N-acetylcysteine used in acute tracheostoma obstruction

Published online by Cambridge University Press:  02 October 2014

A Patel  and
C Theokli
A Patel*
Affiliation:
ENT Department, Lewisham Hospital, London, UK
C Theokli
Affiliation:
ENT Department, Lewisham Hospital, London, UK
*
Address for correspondence: Dr Ankit Patel, 9 Elstree Hill, Bromley, Kent BR1 4JE, UK Fax: 020 8333 333 E-mail: ankitpatel@doctors.org.uk
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Abstract

Background:

Patients with laryngectomy tracheostomas are at risk of developing acute airway obstruction due to mucous crusting. Current management relies on saline nebulisers, followed by suction and manual evacuation to remove the obstruction. This paper describes the first reported case of using N-acetylcysteine nebulisers in addition to saline to adequately soften the mucous plugs in order to facilitate removal.

Case report:

A 68-year-old female attended the emergency department with a partial obstruction of her laryngectomy tracheostoma as a result of mucous crusting. Saline nebulisers did not provide adequate softening to allow the obstructing mucous plugs to be removed. N-acetylcysteine nebulisers were used to further soften the mucous plugs which successfully resulted in their removal.

Conclusion:

N-acetylcysteine nebulisers can be used to assist in the removal of mucous plugs in saline-resistant cases.

Keywords

LaryngectomyAirway ObstructionAcetylcysteineMucusSurgical Stomas
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 12 , December 2014 , pp. 1123 - 1124
Copyright
Copyright © JLO (1984) Limited 2014 

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