[Crescent moon-type tracheobronchial malacia alleviated by placement of stents in trachea and main bronchi].
We encountered a case of crescent-type tracheobronchomalacia in a 54-year-old male smoker. The patient experienced extreme obstructive pulmonary changes but his FVC and DLco findings were within the normal ranges. Plain chest X-ray films indicated tracheal narrowing, a diagnosis that was confirmed by fiberoptic bronchoscopy. Two Z-stents were implanted in the trachea but the patient's symptoms did not subside. Thoracic computed tomography (CT) elucidated stenosis of both main bronchi at end-expiration. The implantation of Z-stents in the main bronchi remarkably alleviated the symptoms and improved peak expiratory flow. Six months after implantation, the tracheal stents broke. A favorable course was obtained by inserting an ultraflex stent inside the broken Z-stents. DLco is important to the diagnosis of tracheobronchomalacia, whereas peak expiratory flow and thoracic CT findings are useful in evaluating the effectiveness of treatment. We concluded that ultraflex stents should be the first choice for treatment of tracheal stenosis, and that Z-stents are appropriate for the treatment of bronchial obstruction.
Tazaki
G
G
Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Kondo
T
T
Kamio
K
K
Hayasi
Y
Y
Ohta
Y
Y
D001980:Bronchi; D001982:Bronchial Diseases / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D015607:Stents; D014057:Tomography, X-Ray Computed; D014132:Trachea; D014133:Tracheal Diseases / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome