A Dedicated Z-Stent for Acquired Saber-Sheath Tracheobronchomalacia

Kishi, Kazushi; Fujimoto, Hisashi; Sonomura, Tetsuo; Uetani, Kosaku; Nishida, Norifumi; Ohata, Masahiro; Sato, Morio; Yamada, Ryusaku

doi:10.1007/s002709900194

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…In addition, if the stent is to be used for obstruction due to malacia, it is best to use a flexible stent that is able to contract and expand to withstand the high degree of dynamic stress present in the malacic airway. 31 For malignant obstructions, in which intraluminal extension of tumor is present or likely, a stent with solid walls or coating is advantageous for preventing tumor ingrowth through the stent. If tumor ingrowth or growth beyond the ends of the stent occurs, it is important to have a stent that is removable or that is not flammable so that a laser can be used to reestablish patency of the airway.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Airway Stent Team: A Comprehensive Approach and Protocol for Tracheobronchial Stent Treatment

Mair¹,

Lyon²,

Jones³

et al. 2000

Ann Otol Rhinol Laryngol

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Tracheobronchial stents are being used with increasing frequency to treat major airway obstruction from both malignant and benign processes. Traditionally, stents have been placed via rigid bronchoscopy, flexible bronchoscopy, or fluoroscopy by members of various individual disciplines. We describe a novel multidisciplinary airway stent team (MAST) protocol for tracheobronchial stent placement and endoscopic management of major airway obstruction. A patient with symptoms of airway obstruction is generally first evaluated with a computed tomography scan and a videotaped flexible bronchoscopy. These studies are reviewed by the team otolaryngologist, pulmonologist, and interventional radiologist. A treatment plan, including the type and location of stents and the need for adjuvant therapies, is formulated. Stent placement is performed in the operating room under general anesthesia. Rigid bronchoscopy, with flexible bronchoscopy and fluoroscopy as needed, allows precise stent placement and the best use of various therapeutic methods. The MAST protocol combines the skills, knowledge, and unique therapeutic options of specialists from otolaryngology, pulmonology, and interventional radiology. This approach allows optimal stent placement and the use of other endobronchial therapies, including laser ablation, balloon dilation, photodynamic therapy, cryotherapy, and brachytherapy. A protocol with representative case reports is presented, along with a review and comparison of several of our most commonly used stents. Otolaryngologists who practice bronchoesophagoscopy, by virtue of their operative skill and knowledge of airway management, are well equipped to become leaders of MASTs and are encouraged to initiate MASTs at their institutions.

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Section: Discussionmentioning

confidence: 99%