Case Study on Tracheo - Bronchial Stenosis: Conservative vs Bronchoscopic Approach

Abstract

Tracheo-bronchial stenosis can occur in infections like tuberculosis, malignancy and post- intubation, trauma to airway. Tracheal and airway stenosis remains a challenging area for pulmonologists and require interventions to cure the patients. The aim of this study is to differentiate treatment approach in the management of variety of tracheo-bronchial stenosis.   Patients with stenosis presents with breathlessness, stridor, hoarseness of voice, and are unable to expectorate. In some cases, patient will require emergency intubation and securing the airway before the treatment of stenosis. Intubation may cause mucosal damage and inflammation, granulation tissue formation, cartilage destruction, tracheomalacia and tracheal stenosis. Among these, post intubation tracheal stenosis has worst outcome and require interventions. Early diagnosis of this complication may change the natural history of the disease. If early diagnosis can be established, then bronchoscopy and balloon dilatation, stenting can be done, otherwise patient might have to undergo further resectional lung surgeries or tracheostomy depending on the site of the lesion. Each case of tracheo-bronchial stenosis needs different treatment approach and careful clinical and bronchoscopic evaluation.