title: Novel use of a disposable curved stent insertion plastic device for silicone stent placement in patients with limited neck extension.
abstract: As granulation tissue formation frequently complicates the insertion of metallic tracheobronchial stents in patients with longer life expectancy, the inert silicone tracheobronchial stent remains the treatment of choice for inoperable benign tracheal stenosis. Similarly, the Y silicone stent insertion also plays an important role for refractory malignant stenoses involving the carina and tracheobronchial junction. The classic insertion method of a straight or Y silicone stent requires rigid bronchoscopy under general anesthesia with a hyperextended neck. This is not an option for patients with limited neck extension. We report a novel method of silicone stent insertion using a disposable curved stent insertion plastic device to solve the problem in 2 patients. The new device may have a role in managing patients with central airway obstruction but limited neck extension. As a valuable alternative to conventional rigid bronchoscope, it also adds to the ease of the silicone stent placement.
authors.affiliation: *Division of Pulmonary and Critical Care Medicine †Division of Thoracic Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan ‡Department of Respiratory and Infectious Diseases, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Li-Han
authors.initials: LH
authors.lastname: Hsu
authors.forename: Chia-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Seiichi
authors.initials: S
authors.lastname: Nobuyama
authors.forename: Teruomi
authors.initials: T
authors.lastname: Miyazawa