Use of 3-Dimensional Computed Tomography Reconstruction Studies in the Preoperative Assessment of Patients Undergoing Balloon Dilatation for Tracheobronchial Stenosis

Abstract

Background: Balloon dilatation (BD) is a useful method of treating tracheobronchial stenosis (TBS); however, accurate preoperative identification of the lesion is difficult. Three-dimensional computed tomography (3D-CT) is an imaging method that may allow more accurate definition of the lesion(s) preoperatively. Study Objective: It is the aim of this study to present our finding using 3D-CT as a part of the preoperative evaluation of patients with TBS undergoing BD. Methods: We studied a prospective case series of 17 consecutive patients who underwent 29 BDs for TBS from a variety of benign and malignant causes at a tertiary care hospital. All patients had a preoperative spiral CT; these data were processed by a software program, VIDA, which was developed at this institution, and 3D-CT reconstruction images of the TBS were created. This enabled accurate preoperative anatomic definition of the lesion. The patients subsequently underwent BD. Results: All 17 patients had lesions identified with 3D-CT. Six patients had tracheal lesions and 12 patients had main stem lesions. One patient had combined tracheal and main stem lesions and 2 other patients had bilateral main stem lesions. Nine out of 17 patients required only one BD. One patient had a failed BD. The remaining 6 patients required more than one BD for optimal results (up to a maximum of 4). The follow-up period ranged from 1 to 34 months. Conclusions: 3D-CT offers accurate definition of TBS, including anatomic location, number of lesions present and status of airway distal to lesion. In this study, all preoperative lesions were correctly identified prior to BD.

Changes in the Levels of Interferon-γ and Transforming Growth Factor-β Influence Bronchial Stenosis during the Treatment of Endobronchial Tuberculosis

“…Third, bronchoscopy cannot reveal the peribronchial or mediastinal lymph node enlargement. Chest CT with 3-dimensional reconstruction may compensate for this disadvantage of bronchoscopy, which allows for a more accurate definition of the airway and will demonstrate the anatomy of the lesion with respect to other mediastinal organs and great vessels [22]. In this study, chest CT detected bronchial narrowing ranging from total obstruction to near-normal stenosis in as much as 87.5% of patients with the exception of 1 case of mild mucosal lesion and 1 case of segmental bronchial lesion.…”

Manejo da estenose traqueal distal recidivada por meio de endoprótese: relato de caso

“…On group of authors found that, in patients with tracheobronchial stenosis, reconstruction CT has a sensitivity of 100%. (9) It is essential to rule out the presence of any type of concomitant laryngeal lesion prior to repairing the tracheal lesion.…”

Bronchoscopic Balloon Dilation (BBD) for Benign Tracheobronchial Stenosis

“…The required length of balloon is estimated by passing the bronchoscope through the stenosis and by measuring the distance between the proximal and distal limits of the obstruction. Three-dimensional CT is a useful noninvasive evaluation for BBD (Rooney et al, 2005). It allows for preoperative determination of balloon size and length, even if the bronchoscope cannot be passed through the obstruction.…”