Conservative management of airway tear as a complication of silicone endobronchial stenting in bronchomalacia secondary to endobronchial tuberculosis

Abstract

Tracheobronchial stenosis due to tuberculosis (TSTB) is a potentially debilitating complication of endobronchial tuberculosis (EBTB). Endobronchial interventions including silicone stent insertion is an acceptable approach to improve quality of life among patients with TSTB. However, little is known about the optimal management strategy for patients with bronchomalacia secondary to EBTB (B-EBTB) and whether stent-related complication rates are higher among this group of patients. Herein, we report two patients with B-EBTB who unfortunately developed bronchial tear related to silicone endobronchial stenting. Both patients were successfully managed conservatively without the need for emergency open surgery. We hypothesize that endobronchial intervention might be more beneficial for patients with pure TSTB and might be riskier in cases of bronchomalacia with reduced airway thickness and loss of airway cartilaginous support. More future studies are needed to bridge the current gap in knowledge regarding the optimal management and role of endobronchial interventions among patients with B-EBTB.

Topical mitomycin‐C as an adjuvant to multimodal endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis

“…Two of our patients with TSTB who developed rapid recurrence of symptoms post intervention had concurrent bronchomalacia (case 3 and case 6). Besides, airway intervention might be riskier in cases of bronchomalacia related to EBTB with reduced airway thickness and loss of airway cartilaginous support [24]. On the other hand, Shirit et al demonstrated that TSTB patients needing more than one session of endoscopic airway intervention will subsequently require more definitive treatment in the form of either airway stent insertion or airway surgery [15].…”