Abstract
A 22-year-old male was transferred to a hospital after a motorcycle crash. He was in serious condition on admission with brain injury, bilateral hemopneumothorax, mediastinal and subcutaneous emphysemas, fracture of the right clavicle and paralysis of the right brachial plexus. His general condition improved, but one month after the injury, radiologic studies revealed complete atelectasis of the right lung secondary to stenosis of the right main bronchus by traumatic disruption. Bronchoscopy disclosed that the right main bronchus was markedly stenotic due to granulation tissue. An Nd-YAG laser treatment of the stenotic lesion was done via fiberoptic bronchoscopy, but this procedure could maintain the airway for only a few days because of restenosis due to granulation tissue. Until the operation for right brachial plexus paralysis performed at our hospital three months after the injury, treatment with Nd-YAG laser vaporization as adjuvant therapy was performed four times. Ten more laser vaporization sessions were followed by surgical repair of bronchial rupture (circumferential resection of the right main bronchus with end-to-end anastomosis) performed nine months after the injury. The postoperative course was uneventful. Seven months after the operation, a bronchoscopic study revealed that the air way was patent and no granulation was observed.
