Abstract
Background. Post-intubation or post-tracheostomy tracheal granulation is considered to be a possible cause of serious central airway stenosis. Case. A 60-year-old woman underwent tracheostomy after subarachnoid hemorrhage. Tracheostomy was closed, however, after 3 years, she again underwent intubation and tracheostomy due to aspiration. She was referred to our hospital for the treatment of difficulty in decannulation. Bronchoscopic examination revealed a 7-mm-long tracheal stenosis, proximal from the tracheostomy site. Considering the risk of perioperative management and her condition after subarachnoid hemorrhage, she underwent endobronchial electrocautery with a direct laryngoscope under general anesthesia. Dumon stent placement was simultaneously conducted to prevent restenosis. She could speak with a speech cannula and the patency of the trachea above the tracheostomy site was good after endobronchial treatment and Dumon stent placement. Conclusion. Endobronchial treatment can become one of the useful procedures for the management of post-intubation or post-tracheostomy tracheal stenosis. The concomitant use of a direct laryngoscope with a bronchoscope makes it possible to safely and easily place a Dumon stent under direct vision for the treatment of tracheal stenosis just below the vocal cord.
