The surgical approach of late-onset tracheoesophageal fistula in a tracheostomized COVID-19 patient

Authors' Response

Dear Editor, We thank Dr. Amore et al. for the comments, and suggestions that allowed us to discuss "The surgical approach of late-onset tracheoesophageal fistula in a tracheostomized COVID-19 patient", published in Monaldi Archives of Chest Disease by our group...

Tracheoesophageal Fistula as a Complication of Prolonged Ventilation in COVID-19: Description of Reconstruction and Review of the Literature

Infection with COVID-19 pneumonia may necessitate intubation and mechanical ventilation. Viral inflammation and pressure necrosis may lead to scarring, stenosis, and in severe cases, fistula formation. Nonmalignant tracheoesophageal fistulas (TEF) represent a surgical challenge and may necessitate locoregional tissue transfer and tracheal resection to prevent recurrence and maintain airway patency. We present a case of TEF in a 63-year-old female secondary to prolonged mechanical ventilation in the setting of COVID pneumonia, detailing the clinical findings and surgical repair. Primary closure of the esophageal defect with pectoralis major muscle flap onlay and tracheal resection, with median sternotomy for access, provided successful intervention, allowing for subsequent tracheostomy decannulation and return to a complete oral diet. This case offers further evidence of the increased risk of airway complications in COVID-19 infection and provides otolaryngologists with an example of a rare surgical approach useful in management.

Comments on "The surgical approach of late-onset tracheoesophageal fistula in a tracheostomized COVID-19 patient"

Dear Editor, We have read with interest the case reported by Rotolo et al. (published in February 2023) concerning the surgical management of tracheoesophageal fistula in a COVID-19 patient treated with prolonged mechanical ventilation for severe respiratory failure...