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OBJECTIVE: The surgical resection used to be the mainstay therapeutic approach for benign tracheal stricture (BTS). Bronchoscopic balloon dilatation (BBD) is a valuable tool in the management of benign tracheal strictures. This retrospective study aims to assess its usefulness and the long-term outcome following minimally invasive BBD.
METHODS: 56 balloon dilatation procedures (repeat range 2-14 times) were performed for 11 patients for benign tracheal strictures between 2001 and 2013 using the fluoroscopic contrast Cordis tracheal balloon 18 - 25mm using 4 - 6 atm pressures.
RESULTS: The main indication for intervention was severe stridor in almost all of these cases. The etiology for stricture in 3 cases was post-intubation, 2 Wegener’s granulamotosis, 1 post radiotherapy, 1 Good’s syndrome, 1 Inflammatory, 1 post tracheostomy, 1 severe inhalational burns and 1 secondary to panniculitis and trachea-esophageal fistula who needed 14 dilatation sessions. The patients were oxygenated well at the start of procedure using the venturi ventilation and balloon would be inflated for 1-2 minutes. Procedure was performed as a day case in majority (82%) apart from 2 complicated cases of stricture (severe burns and trachea-esophageal fistula) following prolonged ventilation. None of the patients we described mandated further surgical tracheal resection.
CONCLUSIONS: This is a technique we used for several years, has proved to be effective in virtually all types of BTS. The results are extremely encouraging and gratifying and we do recommend this as a first line treatment for BTS, which are very likely to obviate the need for surgery.