An unusual early onset post-intubation tracheal stenosis

Background and Objectives: Tracheal or bronchial tears are potential complications of rigid bronchoscopy. This study aimed to investigate the acute complications and outcomes of using an insulation-tipped (IT) knife in combination with rigid bronchoscopic dilatation for treating benign tracheobronchial stenosis. Materials and Methods: We conducted a chart review of patients with benign tracheobronchial stenosis who were treated with rigid bronchoscopy and an IT knife at two referral centers. Treatment success was defined as a clinically stable state without worsening symptoms after 3 months of treatment. Results: Of the 23 patients with benign tracheobronchial stenosis, 15 had tracheal stenosis and 6 had main bronchial stenosis. Among them, three cases were of simple stenosis (13%), while the others were of complex stenosis (87%). The overall treatment success rate was 87.0%. Pneumomediastinum and subcutaneous emphysema occurred due to bronchial laceration in two cases of distal left main bronchial stenosis (8.7%), and no other significant acute complications developed. Silicone stents were inserted in 20 patients, and successful stent removal was possible in 11 patients (55.0%). Six of the seven stents inserted in patients with post-intubation tracheal stenosis were removed successfully (85.7%). However, most of the patients with post-tracheostomy tracheal stenosis required persistent stenting (80%). Pulmonary function was significantly increased after treatment, and the mean increase in the forced expiratory volume in 1 s was 391 ± 171 mL (160–700 mL). Conclusion: The use of an IT knife can be suggested as an effective and safe modality for rigid bronchoscopic treatment of benign tracheobronchial stenosis.

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Topical application of mitomycin-C as an adjuvant treatment to bronchoscopic procedures in post-intubation tracheal stenosis

Revista Portuguesa de Pneumologia (English Edition) ◽

10.1016/j.rppnen.2013.10.003 ◽

2013 ◽

Vol 19 (6) ◽

pp. 276-280

Author(s):

F. Viveiros ◽

J. Gomes ◽

A. Oliveira ◽

S. Neves ◽

J. Almeida ◽

...

Keyword(s):

Mitomycin C ◽

Topical Application ◽

Tracheal Stenosis ◽

Adjuvant Treatment ◽

Post Intubation

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Factors affecting occurrence of post intubation and post tracheostomy tracheal stenosis in intensive care units

Egyptian Journal of Ear Nose Throat and Allied Sciences ◽

10.21608/ejentas.2019.4305.1025 ◽

2020 ◽

Vol 21 (1) ◽

pp. 1-4

Author(s):

Mohammed Roushdy ◽

Hala Abdel-Ghaffar ◽

Ahmed Saleh

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Tracheal Stenosis ◽

Factors Affecting ◽

Post Intubation

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Difficult intubation and anesthetic management in an adult patient with undiagnosed congenital tracheal stenosis: a case report

Journal of International Medical Research ◽

10.1177/0300060520911267 ◽

2020 ◽

Vol 48 (4) ◽

pp. 030006052091126

Author(s):

Ji-A Song ◽

Hong-Beom Bae ◽

Jeong-Il Choi ◽

Jeonghyeon Kang ◽

Seongtae Jeong

Keyword(s):

Case Report ◽

Difficult Airway ◽

Endotracheal Tube ◽

Adult Patient ◽

Tracheal Stenosis ◽

Difficult Intubation ◽

Anesthetic Management ◽

Congenital Tracheal Stenosis ◽

Post Intubation ◽

Unusual Situation

In the operating room, unanticipated difficult intubation can occur and anesthesiologists can experience challenging situations. Undiagnosed tracheal stenosis caused by congenital factors, trauma, tumors, or post-intubation injury, can make advancing the endotracheal tube difficult. We present an adult patient in whom we were unable to pass an endotracheal tube into the trachea. This was caused by undiagnosed congenital mid-tracheal stenosis with complete tracheal rings. When faced with an unanticipated difficult airway, the anesthesiologist needs to comprehend the results of preoperative evaluations. If an unusual situation (e.g., congenital tracheal stenosis) occurs, active cooperation with other departments should be considered.

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