Interventional bronchoscopy for stent placement by rigid brochoscope through tracheostomy. A case reports

H. Anh Duc*^a (Dr), VV. Giap^a (Prof), NN. Du^a (Dr)

^a Bach Mai hospital, Hanoi, VIET NAM

* hoanganhduc@hmu.edu.vn

Introduction

Benign tracheal stenosis that is a debilitating and potentially life-threatening condition. Main causes including: long term of endotracheal intubation and/or tracheostomy; tuberculosis; burn injuries;…

Case report

A34 year-old man admitted to the hospital because of dysapnea. Past medical history: Underwent a surgery to treat traumatic brain injury due to traffic accident 2 months ago. He was intubated and had a tracheostomy for 1 month in the postoperative period. After removing the tracheostomy cannula, the patient often had shortness of breath and stridor.

One day before admission, he had severe shortness of breath which led him to be intubated. The patient has been diagnosed: Scaring tracheal stenosis due to prolonged intubation with post-craniectomy for traumatic brain injury.

We decided to put the rigid bronchoscope through the tracheostomy with the collaboration of otolaryngologists. Finally, the silicone stent was put exactly in the tracheal through the rigid bronchoscope. After the procedure, the patient showed clinical improvement and extubation.

Discussion

The patient had a tracheal stenosis with acute complications of respiratory failure requiring endotracheal intubation to maintain ventilation. In addition, the patient also had brain damage that required surgery. Placing a rigid bronchoscope through the mouth will require head movement leading to the risk of brain damage. Placing a rigid bronchoscope through the tracheostomy avoids the need to move the patient's head and reduces the patient's risk of brain damage. In coclusion, interventional bronchoscopy is an efficient and safe modality in post-intubation tracheal stenosis management and in addition to the traditional oral approach.

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