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airway stenoses

Donnacha J McGrath, Anja Lena Thiebes, Christian G Cornelissen, Mary B O'Shea, Barry O'Brien, Stefan Jockenhoevel, Mark Bruzzi, Peter E McHugh
Tracheobronchial stents are most commonly used to restore patency to airways stenosed by tumour growth. Currently all tracheobronchial stents are associated with complications such as stent migration, granulation tissue formation, mucous plugging and stent strut fracture. The present work develops a computational framework to evaluate tracheobronchial stent designs in vivo. Pressurised computed tomography is used to create a biomechanical lung model which takes into account the in vivo stress state, global lung deformation and local loading from pressure variation...
April 19, 2017: Biomechanics and Modeling in Mechanobiology
Ivan Keogh, Rohana O'Connell, Sean Hynes, John Lang
Subglottic Eosinophilic Angiocentric Fibrosis (EAF) is an extremely rare disease of an elusive aetiology. It is chronically progressive benign condition that causes narrowing of the subglottic region leading to dysphonia and airway compromise. The diagnosis is historical and imaging is nonspecific. We report a case xc of 56-year-old lady referred to our institution with globus sensation, hoarseness, and mild stridor. Incidental subglottic mass was found at time of diagnostic microlaryngoscopy and biopsy confirmed subglottic EAF...
2017: Case Reports in Otolaryngology
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
Emmanuel Martinod, Joseph Paquet, Hervé Dutau, Dana M Radu, Morad Bensidhoum, Sébastien Abad, Yurdagül Uzunhan, Eric Vicaut, Hervé Petite
BACKGROUND: Airway transplantation remains a major challenge in thoracic surgery. Based on our previous laboratory work, we developed the techniques required to bioengineer a tracheal substitute in vivo using cryopreserved aortic allografts as biological matrices (Replacement of the Airways and/or the Pulmonary Vessels Using a Cryopreserved Arterial Allograft [TRACHEOBRONCART] Study, NCT01331863). We present here 2 patients who had a definitive tracheostomy for complex laryngotracheal stenoses refractory to conventional therapy...
January 18, 2017: Annals of Thoracic Surgery
Wenxian Chen, Pengfei Gao, Pengcheng Cui, Yanyan Ruan, Zhi Liu, Yongzhu Sun, Ka Bian
OBJECTIVE: To systematically study various surgical approaches for treating complex hypopharyngeal and/or laryngotracheal stenoses at a variety of sites and levels. PATIENTS AND METHODS: We retrospectively analyzed the treatment of 17 patients with severe and complex hypopharyngeal and/or laryngotracheal stenosis at various sites and levels of severity. All of the 17 patients initially had a tracheostomy. Thirteen had failed the previous laser lysis and/or dilation treatment...
2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Philippe A Grenier, Catalin I Fetita, Pierre-Yves Brillet
Asthma is a heterogeneous condition and approximately 5-10% of asthmatic subjects have severe disease associated with structure changes of the airways (airway remodeling) that may develop over time or shortly after onset of disease. Quantitative computed tomography (QCT) imaging of the tracheobronchial tree and lung parenchyma has improved during the last 10 years, and has enabled investigators to study the large airway architecture in detail and assess indirectly the small airway structure. In severe asthmatics, morphologic changes in large airways, quantitatively assessed using 2D-3D airway registration and recent algorithms, are characterized by airway wall thickening, luminal narrowing and bronchial stenoses...
February 2016: Quantitative Imaging in Medicine and Surgery
Dustin M Walters, Douglas E Wood
Airway endoscopy has long been an important and useful tool in the management of thoracic diseases. As thoracic specialists have gained experience with both flexible and rigid bronchoscopic techniques, the technology has continued to evolve so that bronchoscopy is currently the foundation for diagnosis and treatment of many thoracic ailments. Airway endoscopy plays a significant role in the biopsy of tumors within the airways, mediastinum, and lung parenchyma. Endoscopic methods have been developed to treat benign and malignant airway stenoses and tracheomalacia...
March 2016: Journal of Thoracic Disease
Jonathan C Kopelovich, Todd M Wine, Michael J Rutter, Max B Mitchell, Jeremy D Prager
Slide tracheoplasty is used in cases of tracheal stenosis or injury. With expanding indications for its use at tertiary centers, salvage techniques for dehiscence or restenosis after slide tracheoplasty are increasingly relevant. We present a case in which slide tracheoplasty was augmented with an anterior costochondral graft that stenosed again and ultimately failed. We salvaged this airway emergency by performing a secondary reverse slide tracheoplasty. Using this technique, we were able to establish a safe and durable airway using only native airway tissue...
March 2016: Annals of Thoracic Surgery
Anja Lena Thiebes, Manuel Armin Reddemann, Johannes Palmer, Reinhold Kneer, Stefan Jockenhoevel, Christian Gabriel Cornelissen
INTRODUCTION: Inoperable airway stenoses are currently treated by placing stents. A major problem of covered stents is missing mucociliary clearance, which is caused by covering the native respiratory epithelium. By coating a stent with respiratory epithelium, this problem can be overcome. However, no methods are available for efficient endoscopic cell seeding. METHODS: We designed a flexible endoscopic spraying device based on a bronchoscope and tested it with respiratory epithelial cells...
April 2016: Tissue Engineering. Part C, Methods
Ludek Stehlik, Vladislav Hytych, Jana Letackova, Petr Kubena, Martina Vasakova
BACKGROUND: Biodegradable stents that disintegrate after a period of time are expected to be well tolerated and have advantages over other stents that are more commonly used in practice today. Polydioxanone is a biodegradable polymer that is widely used during surgery with absorbable sutures. METHODS: We present cases from the first four patients to undergo a tracheal polydioxanone stent insertion. Indications included significant non-malignant tracheal stenosis in cases where primary surgical treatment was not possible...
December 21, 2015: BMC Pulmonary Medicine
Yu-Fei Fu, Lu-Lu Lv, Hao Xu, Ning Wei
PURPOSE: We determined the feasibility, safety, and long-term outcome of double stent insertion in management of combined malignant airway and esophageal stenoses (CAES). PATIENTS AND METHODS: Between March 2005 and May 2014, 11 consecutive patients (9 males and 2 females), 56-78 years of age (mean, 63.4 ± 6.1 years), with CAES who underwent double stent insertion (airway and esophageal stents) were enrolled in this retrospective study. Data regarding the technical success, clinical success, and long-term outcome were collected and analyzed...
January 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Saviz Pejhan, Mojtaba Javaherzadeh, Abolghasem Daneshvar, Roya Farzanegan
BACKGROUND: Surgery is an appropriate therapeutic approach for tracheal stenosis due to various benign and malignant conditions. When surgery is postponed for certain reasons, other options are chosen for airway patency. One alternative is using airway stents. OBJECTIVES: We aimed to introduce a safe method of tracheal polyflex stent placement in patients with tracheal stenoses. PATIENTS AND METHODS: During a 7-year period (2002 - 2008), polyflex stents were used 29 times among 20 patients for various indications...
August 2015: Iranian Red Crescent Medical Journal
A Marra, L Hillejan, D Ukena
A lung abscess is an infectious pulmonary disease characterised by the presence of a pus-filled cavity within the lung parenchyma. The content of an abscess often drains into the airways spontaneously, leading to an air-fluid level visible on chest X-rays and CT scans. Primary lung abscesses occur in patients who are prone to aspiration or in otherwise healthy individuals; secondary lung abscesses typically develop in association with a stenosing lung neoplasm or a systemic disease that compromises immune defences, such as AIDS, or after organ transplantation...
October 2015: Zentralblatt Für Chirurgie
Christopher M Johnson, John T Howell, Donald J Mettenburg, Frederick A Rueggeberg, Rebecca J Howell, Gregory N Postma, Paul M Weinberger
OBJECTIVES: Balloon dilation is generally considered first-line treatment for airway stenosis. Some dilation systems utilize a compliant balloon that can conform around rigid structures. Others use a noncompliant balloon that does not conform, allowing for dilation of more rigid stenoses. We hypothesized that subglottic dilation with a noncompliant balloon increases the likelihood of fracture of the cricoid when compared to a compliant balloon. METHODS: Three fresh human cricoid cartilages were placed in a universal testing system to determine the expansile force necessary for cricoid fracture...
January 2016: Annals of Otology, Rhinology, and Laryngology
H V S Fonseca, H V S Fonesca, L R Iuamoto, H Minamoto, L G Abdalla, L M Fernandes, P C L Camargo, M N Samano, P M Pêgo-Fernandes
BACKGROUND: Airway complications after lung transplantation are the major cause of morbidity, affecting up to 33% of all cases. Bronchial stenosis is the most common complication. The use of stents has been established as the most effective therapy; however, their removal is recommended after 3-6 months of use. We have been using self-expandable stents as a definitive treatment and remove them only if necessary. For this report, we evaluated the use of self-expandable stents as a definitive treatment for bronchial stenosis after lung transplantation...
May 2015: Transplantation Proceedings
Ph Monnier, F G Dikkers, H Eckel, C Sittel, C Piazza, G Campos, M Remacle, G Peretti
Adult and pediatric laryngotracheal stenoses (LTS) comprise a wide array of various conditions that require precise preoperative assessment and classification to improve comparison of different therapeutic modalities in a matched series of patients. This consensus paper of the European Laryngological Society proposes a five-step endoscopic airway assessment and a standardized reporting system to better differentiate fresh, incipient from mature, cicatricial LTSs, simple one-level from complex multilevel LTSs and finally "healthy" from "severely morbid" patients...
October 2015: European Archives of Oto-rhino-laryngology
Hubert Löwenheim, H-J Welkoborsky
The surgical management of this problem is a major challenge with various optional surgical procedures. The Chinese authors show in their retrospective analysis the success of laryngotracheal reconstruction (LTR) by cartilage interposition and facial cutaneous flap in patients with complex laryngotracheal stenoses and / or anterior cervical defect.
March 2015: Laryngo- Rhino- Otologie
Carles Sánchez, Jorge Bernal, F Javier Sánchez, Marta Diez, Antoni Rosell, Debora Gil
PURPOSE: Lack of objective measurement of tracheal obstruction degree has a negative impact on the chosen treatment prone to lead to unnecessary repeated explorations and other scanners. Accurate computation of tracheal stenosis in videobronchoscopy would constitute a breakthrough for this noninvasive technique and a reduction in operation cost for the public health service. METHODS: Stenosis calculation is based on the comparison of the region delimited by the lumen in an obstructed frame and the region delimited by the first visible ring in a healthy frame...
June 2015: International Journal of Computer Assisted Radiology and Surgery
Pierre-Yves Brillet, Marie-Pierre Debray, Jean-Louis Golmard, Yahya Ould Hmeidi, Catalin Fetita, Camille Taillé, Michel Aubier, Philippe A Grenier
RATIONALE AND OBJECTIVES: To analyze airway dimensions throughout the bronchial tree in severe asthmatic patients using multidetector row computed tomography (MDCT) focusing on airway narrowing. MATERIALS AND METHODS: Thirty-two patients with severe asthma underwent automated (BronCare software) analysis of their right lung bronchi, with counts of airways >3 mm long arising from the main bronchi (airway count) and bronchial dimension quantification at segmental and subsegmental levels (lumen area [LA], wall area [WA], and WA%)...
June 2015: Academic Radiology
Anna D Dikina, Hannah A Strobel, Bradley P Lai, Marsha W Rolle, Eben Alsberg
There is a critical need to engineer a neotrachea because currently there are no long-term treatments for tracheal stenoses affecting large portions of the airway. In this work, a modular tracheal tissue replacement strategy was developed. High-cell density, scaffold-free human mesenchymal stem cell-derived cartilaginous rings and tubes were successfully generated through employment of custom designed culture wells and a ring-to-tube assembly system. Furthermore, incorporation of transforming growth factor-β1-delivering gelatin microspheres into the engineered tissues enhanced chondrogenesis with regard to tissue size and matrix production and distribution in the ring- and tube-shaped constructs, as well as luminal rigidity of the tubes...
June 2015: Biomaterials
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