Postintubation Tracheal Stenosis Evaluated by Endobronchial Optical Coherence Tomography: A Canine Model Study

Respiration. 2020;99(6):500-507. doi: 10.1159/000506882. Epub 2020 Jun 2.

Abstract

Background: The predictors and airway morphological changes during the development of postintubation tracheal stenosis (PITS) have not been well elucidated.

Objectives: To elucidate the validation of endobronchial optical coherence tomography (EB-OCT) in assessing the airway morphological changes in PITS.

Methods: We performed oral endotracheal intubation in 12 beagles to establish the PITS model. EB-OCT was performed respectively before modeling and on the 1st, 7th, and 12th day after extubation in 9 canines, and was conducted consecutively in 3 canines during the development of PITS. Histological findings and the thickness and gray-scale value of the tracheal wall assessed by EB-OCT measurements were analyzed and compared.

Results: The tracheal wall edema, granulation tissue proliferation, cartilage destruction in PITS, and airway wall thickening detected by EB-OCT were in concordance with the histopathological measurements. The consecutive EB-OCT observation of the airway structure demonstrated the tracheal wall thickness significantly increased from 344.41 ± 44.19 μm before modeling to 796.67 ± 49.75 μm on the 9th day after modeling (p < 0.05). The airway wall gray-scale values assessed by EB-OCT decreased from 111.19 ± 14.71 before modeling to 74.96 ± 4.08 on the 9th day after modeling (p < 0.05). The gray-scale value was negatively correlated with the airway wall thickness (r = -0.945, p = 0.001).

Conclusion: The EB-OCT imaging, in concordance with the histopathological finding, was validated for assessing the airway morphological changes during the development of PITS. The EB-OCT evaluation of cartilage damage and gray-scale value measurement might help predict the development and prognosis of PITS.

Keywords: Airway morphology; Optical coherence tomography; Postintubation tracheal stenosis.

Publication types

  • Validation Study

MeSH terms

  • Animals
  • Bronchoscopy*
  • Dogs
  • Intubation, Intratracheal / adverse effects*
  • Tomography, Optical Coherence*
  • Tracheal Stenosis / diagnostic imaging*
  • Tracheal Stenosis / etiology