Tracheal stenosis mimicking severe acute asthma

Zubairi, Ali Bin Sarwar; Dildar, Babar; Husain, Shahid Javed; Khan, Mohammad Faisal

doi:10.1136/bcr.12.2009.2517

Cited by 3 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Benign tracheal stenosis is a relatively rare yet impactful chronic condition characterised by symptoms such as dyspnoea, inspiratory stridor and poor quality of life. Most commonly, benign tracheal stenosis is observed in young to middle-aged women, which may lead to misdiagnosis of bronchial asthma and therefore delayed diagnosis of benign tracheal stenosis [1][2][3]. There are a few potential causes, including damage from a prior intubation [1], damage from inhaling chemicals or heat, an autoimmune disease, gastro-oesophageal reflux disease (GERD) or an unknown cause, in which case it is known as idiopathic subglottic stenosis [4,5].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic treatment of benign tracheal stenosis: a single-centre study

Kather,

Steinack,

Franzen

2024

Swiss Med Wkly

View full text Add to dashboard Cite

BACKGROUND: Benign tracheal stenosis is relatively rare but remains a significant chronic disease due to its drastic symptoms including dyspnoea and inspiratory stridor, and consequent negative effect on quality of life. Traditionally, the surgical approach by resection of the stenotic tracheal segment has been the therapy of choice. However, endoscopic techniques have arisen and may offer a safe and less invasive alternative. OBJECTIVES: The aim of the retrospective study was to evaluate procedure-related safety and outcome of endoscopic treatment of benign tracheal stenosis at a single centre. METHODS: The study included all patients at our institution who between 2013 and 2022 had received endoscopic treatment of benign tracheal stenosis by rigid tracheoscopy, radial incision by electric papillotomy needle and dilation (endoscopic tracheoplasty) followed by triamcinolone acetonide as a local submucosal injection and additionally, from 2020, budesonide inhalation. RESULTS:A total of 22 patients were treated in a total of 38 interventions, each resulting in immediate improvement of symptoms. There were no peri-interventional complications or mortality. Of the 38 interventions, 11 received no triamcinolone acetonide administration, resulting in a 54.5% recurrence rate after an average of 21.1 (±18.0) months, while 27 had local triamcinolone acetonide, with a 37% recurrence rate. Since 2020, we additionally initiated post-interventional budesonide inhalation as recurrence prophylaxis for newly admitted patients and patients with recurrences(n = 8), of whom only one (12.5%) has to date experienced a recurrence. CONCLUSION: Our results indicate that endoscopic tracheoplasty offers a safe and successful, minimally invasive alternative to open surgery for patients with benign tracheal stenosis. We recommend local administration of triamcinolone into the mucosa as an additional treatment to decrease the risk of recurrence. However, given the uncontrolled study design and low sample size, safety and effectiveness cannot be conclusively demonstrated. Nonetheless, our findings suggest promising avenues for further investigation. Further studies on the additional benefit of inhaled corticosteroids are warranted.

show abstract

Section: Introductionmentioning

confidence: 99%

Endoscopic treatment of benign tracheal stenosis: a single-centre study

Kather,

Steinack,

Franzen

2024

Swiss Med Wkly

View full text Add to dashboard Cite

show abstract

Is It Asthma? Recognizing Asthma Mimics

Gauthier

Fajt

2019

Difficult to Treat Asthma

View full text Add to dashboard Cite

Tracheal Stenosis After Intubation and Tracheostomy in Patients Admitted to Intensive Care Units: A Case-Control Study

Dokoohaki,

Ebrahimzadeh,

Sharifi

2024

Shiraz E-Med J

View full text Add to dashboard Cite

Background: One of the most dangerous complications after endotracheal intubation or tracheostomy is tracheal stenosis. Objectives: This study aimed to determine the personal and clinical characteristics of tracheal stenosis following intubation or tracheostomy in intensive care unit patients. Methods: This is a nested case-control study. Thirty-five patients who suffered from tracheal stenosis from March 2016 to March 2021 and had been intubated and tracheostomized in intensive care units (ICU) were selected for the case group. The control group included 105 patients intubated and tracheostomized in ICU during the same period without tracheal stenosis. A demographic and clinical characteristics questionnaire was used to collect data from the patients' medical records. Results: The mean length of intubation (P < 0.001), endotracheal and tracheostomy tube cuff pressure (P < 0.001), chronic obstructive pulmonary disease (COPD) (P = 0.043), intubation history (P = 0.045), and airway management (P < 0.001) showed significant differences between the case and control groups. The logistic regression model revealed that COPD (OR = 8.519, P = 0.037), intubation history (OR = 3.939, P = 0.013), length of intubation (OR = 1.118, P = 0.003), age (OR = 0.960, P = 0.030), and endotracheal and tracheostomy tube cuff pressure (OR = 1.988, P < 0.001) were associated with tracheal stenosis. The time interval between intubation/tracheostomy ranged from approximately 28 to 938 days. Conclusions: Given the impact of certain care practices during hospitalization on the occurrence of tracheal stenosis, such as the mean length of intubation, endotracheal and tracheostomy tube cuff pressure, and airway management, it is recommended that standardized training on these interventions be prioritized for staff in intensive care departments. Additionally, attention must be given to specific patient characteristics, such as age, COPD, and history of intubation.

show abstract

Tracheal stenosis mimicking severe acute asthma

Cited by 3 publications

References 18 publications

Endoscopic treatment of benign tracheal stenosis: a single-centre study

Endoscopic treatment of benign tracheal stenosis: a single-centre study

Is It Asthma? Recognizing Asthma Mimics

Tracheal Stenosis After Intubation and Tracheostomy in Patients Admitted to Intensive Care Units: A Case-Control Study

Contact Info

Product

Resources

About