Effects of supramaximal balloon dilatation pressures on adult cricoid and tracheal cartilage: A cadaveric study

Durvasula, V S P; Shalin, Sara C.; Tulunay‐Ugur, Ozlem E.; Suen, James Y.; Richter, Gresham T.

doi:10.1002/lary.26872

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…1 Balloon dilation does carry some risk including tracheal laceration, cricoid fracture, and dilation of healthy trachea leading to potential disruption of normal tracheal mucosal tissue. 2 First described in the literature in 2013, CO2 laser wedge excisions are an alternative to traditional balloon dilation. This method involves excision of large wedges of stenotic tissue with preservation of small bridges to allow for re-mucosalization and prevention of circumferential scarring.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Wedge Excisions with CO2 Laser for Subglottic Stenosis

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Endoscopic Wedge Excisions with CO2 Laser for Subglottic Stenosis

et al. 2020

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“…However, tracheal rupture usually does not occur even when high pressure is applied to the tracheal wall, due to the resiliency of the trachea. [ 6 ] Therefore, the factors causing intubation injury also need to be considered. Several studies have found that multiple factors may lead to tracheal rupture following intubation, such as repetitive forceful attempts, overinflation of the balloon cuff, incorrect tube size, and improper tube positioning.…”

Section: Discussionmentioning

confidence: 99%

Tracheal rupture after vocal cord polyp resection

Chen

Cui

et al. 2021

Medicine

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Introduction: Transoral laser microsurgery (TLM) is one of the most common operations performed for glottic lesions. Several protection measures are taken to prevent tracheal damage. However, some protection measures and common postoperative complications may still cause delayed tracheal rupture in certain situations. Cases of tracheal rupture after surgery are extremely rare, and there are no previous reports of TLM of the glottis causing tracheal rupture. Patient concerns: A middle-aged woman who underwent TLM for bilateral vocal cord polyps developed sudden neck pain, followed by cough and subcutaneous emphysema. Diagnosis: She underwent head, neck, and chest computed tomography (CT), which revealed a 4-cm membranous tracheal tear located 4.5 cm distal to the glottis, pneumomediastinum, and subcutaneous emphysema extending from the base of skull to the chest. Interventions: The patient underwent an emergency surgical surgical chest exploration and tracheal repair. Outcomes: One month after the surgery, the patient fully recovered with no tracheal stenosis or respiratory dysfunction. Conclusions: Conventional protective measures and common postoperative complications of TLM may also cause tracheal rupture.

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“…However, it is essential to limit the dilating time, as breathing is stopped during balloon dilatation. Furthermore, the trachea should be carefully observed after cicatricial repair, which may restrict all the tractional forces; it may exhibit a different behavior owing to reduction in its elasticity and strength [11]. Now it is possible to use a tracheal/bronchial balloon whose diameter changes with 3 stages of expansion pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Now it is possible to use a tracheal/bronchial balloon whose diameter changes with 3 stages of expansion pressure. A large mismatch between the balloon catheter diameter and the inner diameter of the airway stenosis may cause edema of the airway walls, bronchial spasm, deep ulceration [10], cartilage fracture, and airway rupture [11]; therefore, it is useful to gradually expand the inner diameter, as predicted by chest CT. In our case, the balloon diameter for dilatation was selected so as to not exceed the tracheal diameter predicted by chest CT, and the pressure required to obtain the expanded diameter was taken as the expansion pressure.…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopic balloon dilatation combined with laser cauterization of high and long segmental tracheal stenosis secondary to endobronchial tuberculosis: A case report

Hanaoka

Ohuchi

Kaku

et al. 2019

Respiratory Medicine Case Reports

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Background Airway stenosis after bronchial tuberculosis may reduce the patient's activities of daily living owing to various respiratory symptoms. Thus, it is necessary to treat the condition. Various treatment modalities, such as balloon dilatation, are attempted in cases where radical surgical resection is difficult to perform; however, the best treatment method remains unknown. Although balloon dilatation is relatively easy to perform and effective, there are not many cases reporting successful treatment of tracheal stenosis as compared to that of bronchial stenosis. Case presentation We report a case involving a 63-year-old man who presented with dyspnea on effort and stridor for 6 months. He was diagnosed with bronchotracheal stenosis due to endobronchial tuberculosis. A chest computed tomography scan showed thickening of the tracheal lumen and deformation of the tracheal cartilage from the annular cartilage to the middle trachea, and severe stenosis in the left main bronchus. Good patency of the trachea and the left main bronchus was obtained after two rounds of balloon dilatation with laser cauterization, which resulted in improvement of symptoms over a relatively long period. Conclusions Our study shows that balloon dilatation combined with laser cauterization can be easily repeated and may be effective for treatment of patients with bronchotracheal stenosis, wherein radical treatment cannot be performed.

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Effects of supramaximal balloon dilatation pressures on adult cricoid and tracheal cartilage: A cadaveric study

Abstract: NA. Laryngoscope, 128:1304-1309, 2018.

Cited by 5 publications

References 18 publications

Endoscopic Wedge Excisions with CO2 Laser for Subglottic Stenosis

Endoscopic Wedge Excisions with CO2 Laser for Subglottic Stenosis

Tracheal rupture after vocal cord polyp resection

Bronchoscopic balloon dilatation combined with laser cauterization of high and long segmental tracheal stenosis secondary to endobronchial tuberculosis: A case report

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