Bronchoscopic retrograde recanalization of complete tracheal obliteration after tracheostomy


      Complete tracheal obliteration after tracheostomy remains a considerable challenge for otolaryngologists and pulmonologists. Here, we report for the first time a novel method of interventional bronchoscopy to successfully recanalize complete tracheal obliteration. Three patients with suprastomal tracheal obliteration and tracheostomy dependence were referred to our center for further management. Using interventional bronchoscopy, a TBNA needle was retrogradely inserted from the stoma to locate the original passage through the occlusion, and then its stylet was left as a guide wire for the sequential dilations. Once the tracheal lumen was restored, endoprosthesis would be implanted to maintain the airway patency. All cases achieved successful recanalization with effortless breathing after the treatment and restored phonation. Bronchoscopic retrograde recanalization using a TBNA needle is a promising and effective treatment for complete tracheal obliteration.


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        • Das P.
        • Zhu H.
        • Shah R.
        • Roberson D.
        • Berry J.
        • Skinner M.
        Tracheotomy-related catastrophic events: results of a national survey.
        Laryngoscope. 2012; 122: 30-37
        • Koitschev A.
        • Simon C.
        • Blumenstock G.
        • Mach H.
        • Graumueller S.
        Surgical technique affects the risk for tracheostoma-related complications in post-ICU patients.
        Acta Otolaryngol. 2006; 126: 1303-1308
        • Koitschev A.
        • Simon C.
        • Blumenstock G.
        • Mach H.
        • Graumüller S.
        Suprastomal tracheal stenosis after dilational and surgical tracheostomy in critically ill patients.
        Anaesthesia. 2006; 61: 832-837
        • Kim S.S.
        • Khalpey Z.
        • Hsu C.
        • Little A.G.
        Changes in tracheostomy- and intubation-related tracheal stenosis: implications for surgery.
        Ann Thorac Surg. 2017; 104: 964-970
        • Koitschev A.
        • Graumueller S.
        • Zenner H.P.
        • Dommerich S.
        • Simon C.
        Tracheal stenosis and obliteration above the tracheostoma after percutaneous dilational tracheostomy.
        Crit Care Med. 2003; 31: 1574-1576
        • Sendi K.
        • Al-Khatib T.
        • Ahmed D.G.
        • Tonkul A.B.
        Management of embedded metallic stents used in the treatment of grades III and IV subglottic, and upper tracheal stenosis in adults.
        Eur Arch Oto Rhino Laryngol. 2014; 271: 2991-2995
        • Ghivizzani S.
        • Oligino T.
        • Robbins P.
        • Evans C.
        Cartilage injury and repair.
        Phys Med Rehabil Clin N Am. 2000; 11 (vi): 289-307
        • Özdemir C.
        • Kocatürk C.I.
        • Sökücü S.N.
        • Sezen B.C.
        • Kutluk A.C.
        • Bilen S.
        • et al.
        Endoscopic and surgical treatment of benign tracheal stenosis: a multidisciplinary team approach.
        Ann Thorac Cardiovasc Surg. 2018; 24: 288-295
        • Yang J.H.
        • Jun T.G.
        • Sung K.
        • Choi J.H.
        • Lee Y.T.
        • Park P.W.
        Repair of long-segment congenital tracheal stenosis.
        J Korean Med Sci. 2007; 22: 491-496
        • Vandemoortele T.
        • Laroumagne S.
        • Bylicki O.
        • Astoul P.
        • Dutau H.
        Endobronchial treatment of complete tracheal stenosis: report of 3 cases and description of an innovative technique.
        Ann Thorac Surg. 2013; 95: 351-354
        • Liu Y.H.
        • Lu M.S.
        • Wu Y.C.
        • Ko P.J.
        • Liu H.P.
        Modified neodymium-YAG laser in rigid bronchoscopy.
        J Laryngol Otol. 2006; 120: 776-777
        • Verkindre C.
        • Brichet A.
        • Maurage C.A.
        • Ramon P.
        • Homasson J.P.
        • Marquette C.H.
        Morphological changes induced by extensive endobronchial electrocautery.
        Eur Respir J. 1999; 14: 796-799
        • Dunlap D.G.
        • Ravenel J.
        • Sechrist J.
        • Semaan R.
        Interventional therapies for central airways.
        J Thorac Imaging. 2019; 34: 49-59
        • Prasad K.T.
        • Dhooria S.
        • Sehgal I.S.
        • Aggarwal A.N.
        • Agarwal R.
        Complete subglottic tracheal stenosis managed with rigid bronchoscopy and T-tube placement.
        Lung India. 2016; 33: 661-663
        • DiBardino D.M.
        • Lanfranco A.R.
        • Haas A.R.
        Bronchoscopic Cryotherapy. Clinical Applications of the Cryoprobe, Cryospray, and Cryoadhesion.
        Ann Am Thorac Soc. 2016; 13: 1405-1415