Recurred Post-intubation Tracheal Stenosis Treated with Bronchoscopic Cryotherapy

Abstract

Post-intubation tracheal stenosis accounts for the greatest proportion of whole-cause tracheal stenosis. Treatment of post-intubation tracheal stenosis requires a multidisciplinary approach. Surgery or an endoscopic procedure can be used, depending on the type of stenosis. However, the efficacy of cryotherapy in post-intubation tracheal stenosis has not been validated. Here, we report a case of recurring post-intubation tracheal stenosis successfully treated with bronchoscopic cryotherapy that had previously been treated with surgery. In this case, cryotherapy was effective in treating web-like fibrous stenosis, without requiring more surgery. Cryotherapy can be considered as an alternative or primary treatment for post-intubation tracheal stenosis.

Post-intubation tracheobronchomalacia in a young adult: A rare case report

“…Post-intubation tracheal stenosis (PITS) is a well-established complication of intubation. It commonly occurs around cuff site due to disruption of local blood supply, with fibrotic replacement of ischemic tissue [7] . The invention of high-volume, low-pressure endotracheal cuff has dramatically resulted in reduction of PITS incidence [7] .…”

“…It commonly occurs around cuff site due to disruption of local blood supply, with fibrotic replacement of ischemic tissue [7] . The invention of high-volume, low-pressure endotracheal cuff has dramatically resulted in reduction of PITS incidence [7] . In this case, the patient's predisposing factors were prolonged intubation, obstructive sleep apnea, and severe hypoxemic respiratory failure.…”

“…The advancement of non-invasive intervention through endoscopy has expanded treatment options for PITS. Commonly performed procedures extend from balloon dilatation, electrocautery, cryotherapy, mitomycin C application, to stent placement [7] . Balloon dilatation requires multiple attempts to obtain satisfactory result and study has shown high relapse rate [9] .…”

Flexible Bronchoscopy Combined with Rigid Bronchoscopy for Treatment of Scarring in the Bronchus Caused by a Foreign Body

“…Cryotherapy has been used to treat malignant and benign airway tumors and remove granulation tissue, FBs, and blood clots. Because of its selective tissue destruction, cryotherapy is less likely to affect the cartilage, collagen, or fat tissues in the airway; thus, the risk of perforation is low [9]. Compared with laser therapy, which is commonly used to treat tracheal stenosis through a rigid bronchoscope, cryotherapy is less likely to cause hemorrhage or perforation, is less expensive, and is relatively simple to perform [8].…”

Postentübasyon trakeal stenoz

“…Bronkoskopi ile tanı koyduğumuz trakeal stenozun morfolojisini, vokal kordlara ana karinaya mesafesini tariflemek hem klinisyenler arasında ortak bir dil oluşturmak hem de tedavi için gerekli planlamayı yapmakta faydalıdır (20). (29,31,32).…”