Benign tracheal stenosis is a complication of endotracheal intubation and tracheostomy. Balloon dilation or laser bronchoscopy relieves symptoms and increasing airway lumen diameter. The benefit of the use of laser as an adjunct to balloon dilation deserves report.
Retrospective chart review of 53 patients with benign tracheal stenosis secondary to endotracheal intubation or tracheostomy treated with balloon dilation with or without laser bronchoscopy. All patients had refused or were not candidates for surgical resection.
Twenty-six patients (17 women, 9 men) had interventions with balloon dilation with or without laser. All had symptomatic dyspnea. A total of 54 dilation interventions (mean 2.07) were performed (balloon dilation 38, balloon dilation with laser 16). All patients had immediate symptomatic relief. A total of 25 (65.8%) repeat interventions for repeat dilation were performed at one year in the balloon dilation group compared with 7 (43.8%) in the balloon dilation with laser group. There were 5 (13%) balloon dilation alone patients versus 4 (25%) in the balloon dilation and laser group who required only one procedure. Additionally, sixteen patients (50%) in the balloon dilation group needed a follow-up procedure for treatment of granulation tissue versus twelve patients (37.5%) in the laser and balloon dilation group.
Laser bronchoscopy as adjunct to balloon dilation for benign tracheal stenosis results fewer interventions and less granulation tissue.
Laser bronchoscopy should be considered as an adjunct to balloon dilation for the treatment of benign tracheal stenosis. A randomized, prospective trial is warranted.
M. Cirino-Marcano, None.