title: Benign tracheal stenosis: a case series analysis.
abstract: Tracheal stenosis (TS) requires a precise diagnosis and an experienced operator in both endoscopic and surgical treatment. We describe a case series at a tertiary care teaching hospital. Twenty patients with TS and/or subglottic stenosis were included. All underwent flexible bronchoscopy (FB). Spirometry (SP) was obtained in 8 patients, and helical computed tomography with three-dimensional reconstruction (HCT3D) was obtained in 11 patients. All cases were graded by each modality on a scale of 1 to 3, and the findings were correlated among modalities. Mean follow-up was 11.1 months (range: 3 to 47 mo). Postintubation injury was the most frequent cause of stenosis in 16 patients (80%). Mean stenosis grade±SD was 2.0±0.92 for SP, 2.3±0.86 for FB, and 2.54±0.68 for HCT3D. A significant correlation was found between HCT3D and FB (r=0.76, P<0.01). There was no correlation between SP and FB (r=0.46, P=0.2) or between SP and HCT3D (r=0.68, P=0.13). Treatment was conservative in 8 patients. Eighteen tracheal dilatation procedures were performed in 7 patients (mean: 2.5 dilatations/patient, range: 1 to 6; mean free time between dilatations 109.7±81 d, range: 6 to 210 d). Tracheoplasty was carried out in 7 patients, with tracheal anastomosis in 4 patients and thyroid-tracheal anastomosis in 3 patients. Tracheostomy was required in 1 patient with scleroma. Neither complications nor mortality related to FB was reported. HCT3D has a good correlation with FB. Tracheal dilatation is a viable option for patients who are not surgical candidates and for those with restenosis of tracheal anastomosis.
authors.affiliation: *Servicio de Neumología, Hospital General de México SSa and Facultad de Medicina, UNAM †Departamento de Cirugía de Cuello, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social ‡CT Scanner del Sur, México, D.F., México.
authors.forename: Pablo
authors.initials: P
authors.lastname: Alvarez-Maldonado
authors.forename: Juan
authors.initials: J
authors.lastname: Peña
authors.forename: José Luis
authors.initials: JL
authors.lastname: Criales-Cortés
authors.forename: Francisco
authors.initials: F
authors.lastname: Navarro-Reynoso
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pérez-Romo
authors.forename: Raúl
authors.initials: R
authors.lastname: Cicero-Sabido