Efficacy of external fixation of a straight silicone stent in the treatment of subglottic stenosis.

Abstract

The incidence of subglottic stenosis is rising year by year. For this difficult clinical problem, the efficacies of surgical and bronchoscopic intervention treatments vary. A simple and effective method to affix silicone stents is needed for the treatment of subglottic stenosis. Eight patients suffering from subglottic stenosis underwent straight silicone stent placement with external fixation in the First Affiliated Hospital of Chengdu Medical College between January 2015 and August 2019. All patients received regular postoperative bronchoscopy. A retrospective analysis was conducted to analyze the efficacy and complications of the operation. Straight silicone stent placement was successful in seven patients and the external fixation of stents was completed. Symptoms of dyspnea were resolved in seven cases (87.5%), and the mean diameter of the upper trachea was significantly increased from 3.54±0.59 to 12.71±2.42 mm after the operation (t=15.78, P=0.002). The modified Medical Research Council dyspnea scale score significantly decreased from 3.4 (2.7, 3.8) to 0.8 (0.4, 1.4) after the operation (Z=-6.63, P=0.001). Postoperative complications were observed, including one case of mediastinal emphysema and pneumothorax, two cases of granulation tissue hyperplasia, four cases of intractable cough, six cases of postoperative infection at the external fixation site, one case of postoperative bleeding, and one case of sputum retention. All were promptly treated and quickly controlled. No stent displacement was observed during follow-up. External fixation of straight silicon stents for the treatment of subglottic stenosis had good short-term outcomes and stable stent fixation. The proportion of postoperative infections was high. Therefore, the advantages and disadvantages of this operation need to be considered.