Tuberculous Stenosis of the Trachea: Report of a Case Treated by Incision

Abstract

We have presented a case of tuberculous ulceration of the trachea (Type III) which progressed to marked stenosis (Type IV). Due to the high mortality rates quoted in the literature in regard to the surgical removal and repair of the lower end of the trachea it was decided to treat conservatively with massive antibiotic therapy combined with repeated local incisions of the constricting band. It is granted that the patient's future is still precarious but she has been kept alive for 15 months since the constrictive crisis, she is relatively well, her sputum has been converted and she has returned home to continue convalescence. The atelectasis of her left lung has lessened and her general condition is such that she could now stand excisional therapy for the trachea better than would have been the case when she was so ill in January 1951. The repeated incisions of the constricting tracheal ring were accomplished by a special instrument designed by one of the authors rather than by cautery as it was feared that the reaction to the latter might seriously increase the degree of stenosis.