title: Suspension laryngoscopy for endotracheal stenting.
abstract: OBJECTIVE
  Airway stents have recently been used to establish and maintain patent airways in patients with malignant central airway obstruction, but insertion modalities remain controversial to date. The study seeks to determine the role of suspension laryngoscopy in interdisciplinary airway stenting.
  
  
  METHODS
  Retrospective, single-institution analysis of a case series treated by a multidisciplinary airway team.
  
  
  METHODS
  Ninety-three consecutive patients with malignant obstruction of the trachea and/or tracheobronchial bifurcation underwent endotracheal stenting through a suspension laryngoscopy approach for the relief of impending respiratory distress. Feasibility, mortality, survival, and complications were analyzed as main outcome measures.
  
  
  RESULTS
  Stenting through a suspension laryngoscopy approach was feasible 91 of 93 patients (97.8%). Fifteen patients needed repeated stenting, and in all, 121 stents were implanted during the observation period. This approach allowed for the repeated insertion of rigid bronchoscopes of graded sizes to establish an airway and for precise stent positioning. Optical instruments and stent introducer systems could easily be used while adequate ventilation was continuously maintained. Silicone stents of maximal size were inserted without injury of the vocal cords during intubation. Median survival for all patients was 8 months. No intraoperative airway complications were observed, and no patient died secondary to stenting.
  
  
  CONCLUSIONS
  Suspension laryngoscopy and jet ventilation provide an ideal setting for the precise placement of tracheal and bifurcation airway stents. Laryngologists should actively participate in interdisciplinary airway stenting programs.
authors.affiliation: Department of Otorhinolaryngology, Landeskrankenhaus Klagenfurt, Austria. hno.abteilung@lkh-klu.at
authors.forename: Hans Edmund
authors.initials: HE
authors.lastname: Eckel
authors.forename: Shahindocht
authors.initials: S
authors.lastname: Berendes
authors.forename: Michael
authors.initials: M
authors.lastname: Damm
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Klussmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Wassermann
mesh_terms: D000402:Airway Obstruction / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015607:Stents; D016019:Survival Analysis; D014134:Tracheal Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D014135:Tracheal Stenosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome