title: Outcome of treating airway compromise due to bronchial stenosis with intralesional corticosteroids and cutting-balloon bronchoplasty.
abstract: OBJECTIVE
  To determine the feasibility, safety, and efficacy of treating benign bronchial stenosis with laryngoscopy, jet ventilation, intralesional corticosteroids, and cutting-balloon bronchoplasty.
  
  
  METHODS
  Case series with planned data collection.
  
  
  METHODS
  National airway unit.
  
  
  METHODS
  Ten adult patients with bronchial stenosis caused by Wegener's granulomatosis (n = 6), tuberculosis (n = 2), intubation (n = 1), and photodynamic therapy (n = 1) who underwent bronchoplasty using cutting-balloon dilation via suspension laryngoscopy in 2009. Information about patient demography, etiology, lesion characteristics, and details of the interventions were recorded. Patients underwent spirometry before surgery and at last follow-up. Chest infection rate in the 6 months before bronchoplasty and from bronchoplasty to the last follow-up was ascertained.
  
  
  RESULTS
  There were 3 men and 7 women. Mean age at bronchoplasty was 46 ± 20 years. Length of stay was 1 day in all cases, and no treatment-related complications occurred. One patient required a second bronchoplasty at 55 days. Mean follow-up was 7 ± 2.3 months. Forced expiratory volume in 1 second increased from a prebronchoplasty mean of 1.6 ± 0.6 to 2.2 ± 0.5 at last follow-up (P < .0001; paired Student t test). Forced vital capacity rose from 2.7 ± 0.6 to 3.1 ± 0.6 (P = .02), and peak expiratory flow rate increased from 3.7 ± 0.8 to 5.0 ± 0.8 (P < .0001). Chest infection rate fell from an average of 0.7 ± 0.3 infections per month to 0.2 ± 0.2 (P < .003; paired Student t test).
  
  
  CONCLUSIONS
  Cutting-balloon bronchoplasty via suspension laryngoscopy is an effective treatment for benign bronchial stenosis. It is safer than airway stenting and is less invasive than thoracotomy. The authors propose its use as first-line treatment for this condition.
authors: The National Centre for Airway Reconstruction, Imperial College Healthcare NHS Trust, London, UK. RN@cantab.net
authors: S A Reza
authors: SA
authors: Nouraei
authors: Heide
authors: H
authors: Mills
authors: Colin R
authors: CR
authors: Butler
authors: Khalid
authors: K
authors: Ghufoor
authors: Guri S
authors: GS
authors: Sandhu
authors: P Jeremy
authors: PJ
authors: George
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000188:drug therapy / Q000628:therapy*; D001999:Bronchoscopy; D002404:Catheterization; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006611:High-Frequency Jet Ventilation; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones