Effects of tracheostomy on human tracheobronchial mucosa: a scanning electron microscopic study

The protective functions missing in the upper airways of tracheostomy patients lead to functional and morphological changes in the lower respiratory tract. To obtain detailed data from the surface of the tracheobronchial mucosa, a scanning electron microscopic study was performed. Mucosal biopsies were taken from different sites of the tracheobronchial tree in 5 healthy control subjects, 5 patients with tracheostomy after laryngectomy, and 5 tracheostomy patients not affected by a history of smoking. Following scanning electron microscopic examination, the specimens were evaluated morphometrically. The percentage ciliary border and the individual mucosal surface changes depended on the biopsy site and the degree of previous damage. Individual structural alterations consisted of squamous metaplasia, giant cilia, compound cilia, and microplicae. Giant cilia represented an impressive form of differentiation in chronic bronchitis recognizable by scanning electron microscopy.