Category Archives: Subglottic Tracheal Stents

External Fixation of Subglottic Tracheal Stents: Recommendation

Both angiocatheters are inserted percutaneously, perpendicular to the stent and trachea to avoid perforation of the posterior wall of the trachea and prosthesis. Sutures are tied snuggly, but not tight enough to cause laceration of the anterior wall of the stent. We chose nonabsorbable, blue polypropylene (Prolene), or green braided polyester (Tevdek) sutures because of their known nonreactivity. In addition, these colors are easily discerned … Continue reading

External Fixation of Subglottic Tracheal Stents: Recommendation

Another therapeutic alternative, bronchoscopic laser resection and dilatation, is safe, provides rapid palliation with little associated morbidity, and can be repeated in case of recurrence. When possible, multiple radial incisions of circumferential scar tissue are made with the CO2 or Nd:YAG laser. More recently, the green, 532-nm wavelength (KTP) laser has also been used because of its dual cutting and coagulating properties. When resection is … Continue reading

External Fixation of Subglottic Tracheal Stents: Discussion

An 84-year-old woman with diabetes mellitus, Guillain-Barre syndrome, and respiratory failure requiring intubation, tracheotomy, and prolonged mechanical ventilation was referred for bronchoscopy. Severe tracheal stenosis with malacia and granulation tissue of the upper trachea was discovered. Rigid bronchoscopic laser resection enlarged the subglottic region to 10 mm. A 16 mm/40 mm straight silicone stent was inserted, but would not expand. A 14 mm/40 mm stent … Continue reading

External Fixation of Subglottic Tracheal Stents: Analysis

Purulent drainage was noted at the site of the subcutaneous button. Granulation tissue was again removed and significant tracheomalacia was discovered beyond the distal extremity of the stent. Cultures of bronchial secretions were positive for methicillin-resistant Staphylococcus aureus, but cultures of the cutaneous drainage revealed no organisms. Antibiotics were administered and the patient returned to his home in another state: coughing, but without other symptoms … Continue reading

External Fixation of Subglottic Tracheal Stents: Case Reports

A 68-year-old woman with a history of chronic obstructive pulmonary disease and left upper lobe resection for tuberculosis was referred for increasing dyspnea. Medical history included endotracheal intubation, mechanical ventilation, and permanent tracheotomy after abdominal surgery. The FFB revealed abundant granulation tissue along the anterior tracheal wall in the immediate subglottic region, prompting RB and laser resection. Severe malacia was apparent at the site of … Continue reading

External Fixation of Subglottic Tracheal Stents: Procedure

When necessary, Nd:YAG laser resection was performed using standard techniques. The flexible fiberoptic bronchoscope (FFB) was used through the rigid tube to clear the airways of secretions and blood before and after stent placement. Straight silicone stents were inserted into the area of stenosis using a specially designed instrument (Stent Introducer System, EFER, LaCiotat, France). This system allows stent insertion under direct endoscopic guidance after … Continue reading

External Fixation of Subglottic Tracheal Stents

When tracheal stenosis results from trauma, inflammatory disorders, or prolonged endotracheal intubation, conservation of laryngeal function after treatment is essential review canadian family pharmacy. Management of subglottic stenoses is particularly challenging because open surgical resection is often difficult without a stricture-free subglottic space. In addition, many patients are elderly or have severe underlying illnesses, making them unsuitable candidates for tracheal reconstruction. Tracheostomy followed by Montgomery T-tube … Continue reading