Role of air way stenting (Duman- silica stent) in benign stricture trachea management
DOI:
https://doi.org/10.18203/2349-3933.ijam20190021Keywords:
Air way stenting, Management, Stricture, TracheaAbstract
Background: Tracheal strictures are known to recur after dilatation, so they need stenting to prevent recurrence. The objective was to study role of air way stenting (Duman- silica stent) in benign stricture trachea management.
Methods: A hospital based prospective study was carried out among 15 cases (as these cases are very rare, author could study only 15 cases) presented with various clinical features suggestive of tracheal strictures. They were examined and managed by putting tracheal stent for up to eight months period. All cases were followed at regular intervals till 14months after the stent was placed. The outcome was studied.
Results: The tracheal strictures have been found to be more in the age group of 25-30 years. The male to female ratio was 4:1 i.e. for everyone female case there were four male cases. Thus, the tracheal strictures have been more common among the males compared to the females. All of the patients presented with severe stridor, breathing difficulty, and poor exercise tolerance. Most common cause of tracheal stricture was prolonged mechanical ventilatory support >8 days due to organo phosphorus poisoning in past 3months and all of them were males. All cases had good outcome at the end of 14months of follow up. All cases had normal findings. No one developed foreign body reaction, nor did no one develop granuloma formation at the stent site. After stent removal flexible bronchoscopy repeated after 3rd month and 6th month.
Conclusions: Tracheal stenting is very useful procedure in the management of air way strictures.
References
Ranu H, Madden BP. Endobronchial stenting in the management of large airway pathology. Postgrad Med J. 2009;85(1010):682-7.
Ernst A, Silvestri GA, Johnstone D. Interventional pulmonary procedures. Chest. 2003;123:1693-717.
Mathisen DJ, Morse CR. Thoracic surgery: Lung resections, bronchoplasty. In: Josef E. Fischer, eds. Master techniques in surgery. Philadelphia: Wolters Kluwer, 2014.
Casas DB, Fernández-Bussy S, Folch E, Aldeyturriaga JF, Majid A. Non-malignant central airway obstruction. Arch Bronconeumol. 2014;50(8):345-54.
FDA public health notification: Complications from metallic tracheal stents in patients with benign airway disorders. FDA; 2005. Available at:
http://www.jsre.org/info/0801_fda.pdf.
Karush JM, Seder CW, Raman A, Chmielewski GW, Liptay MJ, Warren WH, et al. Durability of silicone airway stents in the management of benign central airway obstruction. Lung. 2017;195:601-6.
Saueressig MG, Sanches PR, Neto AV, Moreschi AH, Oliveira HG, Xavier RG. Novel silicone stent to treat tracheobronchial lesions: results of 35 patients. Asian Cardiovascul Thoracic Ann. 2010;18(6):521-8.
Musani AI, Jensen K, Mitchell JD, Weyant M, Garces K, Hsia D. Novel use of a percutaneous endoscopic gastrostomy tube fastener for securing silicone tracheal stents in patients with benign proximal airway obstruction. J Bronchol Interventional Pulmonol. 2012;19(2):121-5.
Ho CY, Liao HM, Tu CY, Huang CY, Shih CM, Su MY, et al. Numerical analysis of airflow alteration in central airways following tracheobronchial stent placement. Experimental Hematol Oncol. 2012;1(1):23.
Brigger MT, Boseley ME. Management of tracheal stenosis. Current Opinion Otolaryngol Head Neck Surg. 2012;20(6):491-6.
Karapantzos I, Karapantzou C, Zarogoulidis P, Tsakiridis K, Charalampidis C. Benign tracheal stenosis a case report and up to date management. Ann Translational Med. 2016;4(22):451.
Tsakiridis K, Darwiche K, Visouli AN, Zarogoulidis P, Machairiotis N, Christofis C, et al. Management of complex benign post-tracheostomy tracheal stenosis with bronchoscopic insertion of silicon tracheal stents, in patients with failed or contraindicated surgical reconstruction of trachea. J Thoracic Dis. 2012;4(1):32.