Prospective Observational Trial of a Nonocclusive Dilatation Balloon in the Management of Tracheal Stenosis

Hofmeyr, Ross; McGuire, Jessica; Park, K; Proxenos, M; Peer, Shazia; Lehmann, Markus; Lubbe, Darlene

doi:10.1053/j.jvca.2022.02.004

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…At our institution, the management of adult tracheobronchial stenosis has radically changed since we first began using the non-occlusive balloon in 2017. 6 Use of the device has steadily increased, with more than 650 uses over the three-year period from 2019 to 2021, with; about a quarter of these occurring in our facility. During this time, we have not experienced any significant complications of the procedure.…”

Section: Discussionmentioning

confidence: 97%

“…In our centre, it is currently standard practice to use a supraglottic airway device and a non-occlusive balloon in all patients who present with tracheal or bronchial stenosis requiring urgent surgical intervention. [2][3][4][5][6] We describe a novel technique for dilatation of stenosis that involves a non-occlusive tracheal dilatation balloon through a supraglottic airway device, performed under direct endoscopic vision.…”

Section: Introductionmentioning

confidence: 99%

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How we do it: endoscopic tracheal dilatation technique using a supraglottic airway device and non-occlusive balloon

Hofmeyr

Lubbe

2022

J. Laryngol. Otol.

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Background Tracheal stenosis can be difficult to manage. Dilatation can relieve acute symptoms, avoid emergency tracheostomy and may be curative, but traditional dilators risk injury and obstruction in an already critical airway. This paper describes a novel technique for conducting tracheobronchial dilatation with a non-occlusive balloon through a supraglottic airway device, performed under endoscopic guidance. Technical description A supraglottic airway device is placed whilst the patient is under total intravenous anaesthesia with mechanical ventilation. Using a multiport airway adaptor, inspection is performed by flexible endoscopy and a guidewire is placed through the stenosis. A non-occlusive balloon is advanced over the guidewire and positioned using the endoscope reinserted through the second adaptor port. Ventilation can thus be continued throughout dilatation under vision. Conclusion This technique has revolutionised our approach to tracheal dilatation in our institution. It avoids tracheostomy, and can be safely and reliably performed by junior staff in the emergency setting after adequate training.

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Section: Discussionmentioning

confidence: 97%