Tuberc Respir Dis.  2013 Aug;75(2):79-82.

Tracheal Stenosis after Tracheostomy Treated Successfully with Papillotome Electrocautery

• Oh SH
• Lee SJ
• Kim DS
• Na MJ
• Choi E
• Kwon SJ
• Cho HM
• Son JW

Abstract

A 39-year-old woman presented with symptoms of dyspnea. Ten years previously, she had received a tracheostomy because of the decision to not continue taking an anticonvulsant drug. Presently, chest computed tomography showed diffuse stenosis and focal web at the cervical trachea. We performed bronchoscopy and found a two-thirds reduction of the upper trachea due to the web-like fibrotic stenosis. Papillotome electrocautery removed the stenotic lesion. Endobronchial electrocautery is a valuable tool with potential for therapy of an endobronchial obstructing airway lesion. We report this case to introduce the successful treatment with papillotome electrocautery.

Keyword

Bronchoscopy; Electrocoagulation; Tracheal Stenosis

MeSH Terms

Bronchoscopy
Constriction, Pathologic
Dyspnea
Electrocoagulation
Female
Humans
Thorax
Trachea
Tracheal Stenosis
Tracheostomy

Figure

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  Figure 1 Initial pulmonary function test, bronchoscopy and chest computed tomography (CT) image. (A) Flow volume curve showed fixed obstructed pattern (forced expiratory volume in one second [FEV1,] 89.7%; FEV1/forced vital capacity, 86.47%). (B) Bronchoscopy revealed two-thirds narrowing of upper trachea due to web-like fibrotic stenosis. (C) Chest CT showed diffuse stenosis and focal web at the cervical trachea.

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  Figure 2 Treatment of stenosis by needle knife (A) and papillotome electrocautery (B).

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  Figure 3 Two-month post-operative findings. (A) Flow volume curve showed normal pattern. (B) Bronchoscopy revealed the improvement of tracheal stenosis. (C) Chest computed tomography showed the tracheal obstruction was completely removed.

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