Case series of endoscopic treatment of post-intubation tracheal stenosis

Salim Salloum; Michel Tawk; Ralph Nehme; Dima Siblani; Youssef Haddad

doi:10.1016/j.rmcr.2021.101561

Case series of endoscopic treatment of post-intubation tracheal stenosis

Respir Med Case Rep. 2021 Dec 4:35:101561. doi: 10.1016/j.rmcr.2021.101561. eCollection 2022.

Authors

Salim Salloum^{1

2}, Michel Tawk^{1

2}, Ralph Nehme³, Dima Siblani⁴, Youssef Haddad^{5

6}

Affiliations

¹ Internal Medicine Department - Lebanese Hospital Geitaoui - Lebanese University, Lebanon.
² Masters in Neuroscience - Neuroscience Research Center - Faculty of Medical Sciences - Lebanese University, Lebanon.
³ Pulmonary and Critical Care Department - LAUMC, Lebanon.
⁴ Pulmonary Fellow - Pulmonary and Critical Care Department - Lebanese Hospital Geitaoui, Lebanon.
⁵ Pulmonary and Critical Care Department - Lebanese Hospital Geitaoui, Lebanon.
⁶ Critical Care Division - Lebanese University, Lebanon.

Abstract

Introduction: Benign tracheal stenosis is a common problem encountered after tracheal intubation or tracheostomy. It can be managed by surgical or nonsurgical techniques. This case series describes the outcome of 11 cases of endobronchial treatment for complex tracheal stenoses.

Methods: A retrospective study was carried out in two hospitals in Lebanon. Patients were contacted on a regular basis for 6 months and asked about the presence of dyspnea and its characteristics.

Results: The most common presenting symptom was inspiratory stridor. Five patients (45.45%) were not satisfied after the bronchoscopic intervention. Six patients (54.55%) were satisfied with the outcome. All were initially treated with argon plasma coagulation and dilation. If any persistent symptoms were present, stenting was done. Three patients had a stent placement. Failure of stenting occurred with two patients. None of the satisfied patients had any early symptoms.

Conclusion: Bronchoscopic interventions yielded acceptable results when treating complex stenoses. More data is still needed to guide physicians for better approaches. When confronting complex tracheal stenosis, a multidisciplinary approach between surgical and nonsurgical doctors is preferred to choose the best medical care.

Keywords: Benign stenosis; Complex stenosis; Post intubation stenosis; Tracheal stenosis.

Publication types

Case Reports