Endotracheal Excision of Fibrous Tracheal Stenosis and Subsequent Prolonged Stenting: An Alternative Method in Selected Cases

Abstract

Stenosis of the trachea, especially after prolonged intubation for mechanical ventilation or after direct trauma to the trachea, has become an increasing problem worldwide. The generally accepted treatment of choice is resection of the stenotic part of the trachea and end-to-end anastomosis; however, some patients have primary diseases (multiple injuries, cardiorespiratory failure, severe bronchial asthma, adrenal dysfunction, etc) that contraindicate any major tracheal surgery. In these cases, more conservative methods must be tried. Treatment with dilation using various types of stents, mostly combined with endotracheal excision of fibrous tissue, has been used in 20 patients during the period of 1965 to 1974 at the Department of Otolaryngology, University Hospital, Uppsala, Sweden. In the 17 patients who have completed treatment who have completed treatment (two patients still being treated and one patient died of myocardial infarction during treatment), nine were classified as having good clinical results, four as satisfactory, and four as failures. We believe that treatment of tracheal stenosis using dilation with stents is a reasonably good alternative in patients whose general condition makes them poor risks for major tracheal surgery.