LXIV Histologic Changes in the Trachea following Tracheostomy

Abstract

Histologic changes occurring in the lower respiratory tract following tracheostomy have been analyzed. Specimens of trachea, carina and primary bronchi were obtained at the autopsy examination of 27 patients who had tracheostomies prior to death. Comparable tissues were obtained at autopsy from 44 patients without tracheostomies. Intact epithelium was observed in only 1 of the 27 patients with tracheostomy. In the control group, 34 of the 44 patients exhibited an intact epithelial layer. Carinal or unilateral bronchial ulceration was observed in 8 of 27 patients with tracheostomy and in none of the control group. Various degrees of ulceration, denudation and infection in the lower respiratory tract were observed in 10 of 27 patients with tracheostomy and in 7 of the 44 controls. In the reparative process, regeneration of epithelium was observed in 10 patients with tracheostomy and in none of the control group. In the repair, metaplasia of the respiratory epithelium often occurred. The extent to which this might persist or be promptly reversed remains uncertain. The regenerative process, metaplasia, chronic inflammation and other mucous membrane changes observed in this study of the lower respiratory tract have been recorded and analyzed.