Tag Archives: bronchoscopy

Deliberations of Airway Stabilization With Silicone Stents for Treating Adult Tracheobronchomalacia

There is a need for a higher clinical suspicion and a standardized approach to objectively evaluate for TBM in the patient with dyspnea refractory to traditional therapies. Therapeutic airway stenting is often considered, but evidence for the efficacy of this approach has not been adequately characterized. In this largest prospective study to date, we found that stenting produced statistically significant and clinically important improvement in … Continue reading

Outcomes of Airway Stabilization With Silicone Stents for Treating Adult Tracheobronchomalacia

Of 75 patients referred for assessment of TBM during the study period, 58 had severe TBM and were able to undergo therapeutic rigid bronchoscopy under general anesthesia. The patients included in this study were on average 69 years old (range, 39 to 91 years), and 34 patients (59%) were men. Among all patients, 33 patients had COPD (57%; median FEVb 1.07 L); 13 patients (22%) had … Continue reading

Investigation about Airway Stabilization With Silicone Stents for Treating Adult Tracheobronchomalacia

The institutional review board of Beth Israel Deaconess Medical Center approved the protocol and patients gave written informed consent. We conducted a prospective, observational study from January 2002 to September 2006 in all patients referred to our Complex Airway Center for the evaluation of respiratory symptoms presumed to be caused by TBM. All patients who underwent central airway stenting (tracheal, main-stem bronchus, or both) for … Continue reading

My Canadian Pharmacy: Airway Stabilization With Silicone Stents for Treating Adult Tracheobronchomalacia

Tracheobronchomalacia (TBM) is an abnormal collapse of the tracheal and bronchial walls. It is characterized by flaccidity of the supporting tracheal and bronchial structures and a significant reduction of airway diameter on expiration seen in the trachea and/or in the mainstem bronchi. The prevalence of TBM in adults is unknown. The incidence may be as high as 23% among patients with COPD undergoing bronchoscopy, and … Continue reading

Cavitary Coccidioidomycosis With Fungus Ball Formation: Discussion

The indications for surgical removal of a cavity are variable and include the following: (1) rapidly expanding cavity (> 4 cm) close to visceral pleura with risk of imminent rupture; (2) serious or persistent hemoptysis; (3) symptomatic fungus ball; (4) bronchopleural fistula; (5) persistence greater than 1 year; and/or (6) culture-positive sputum. Underlying host compromise, including diabetes, has been proposed as mandating surgical removal. Surgical … Continue reading

Cavitary Coccidioidomycosis With Fungus Ball Formation: Case 2

A 56-year-old man with a 22-packs/year smoking history presented with a 2-month history of intermittent, weekly hemoptysis of approximately one teaspoonful per episode. He had a history of cardiac disease (two heart attacks), insulin-dependent diabetes mellitus, and hypertension. There were no complaints of fever, chills, night sweats, fatigue, gastrointestinal discomfort, or dyspnea; he had never previously experienced hemoptysis. The previous month he experienced a weight … Continue reading

Cavitary Coccidioidomycosis With Fungus Ball Formation: Case 1

A 20-year-old woman was transferred to Fitzsimons Army Medical Center for evaluation of hematemesis, possible hemoptysis, and a cavity of the right lung. Over a period of 7 years, she had experienced nausea and abdominal pain with intermittent hematemesis; chest pain and hemoptysis were also described. These symptoms, although intermittent, occurred as frequendy as every 1 to 2 weeks. Previously, an upper gastrointestinal barium examination … Continue reading

Cavitary Coccidioidomycosis With Fungus Ball Formation

Infection with the dimorphic fungus, Coccidioides immitis, is common in the southwestern United States and other areas of the lower Sonoran life zone. Inhalation of arthrospores results in pulmonary infection that is usually symptomless and recognized only by skin test conversion. A pneumonia, clinically apparent or not, may resolve completely or persist, and sequelae of the infection may be seen roentgenologically as a nodule or … Continue reading