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Balloon tracheoplasty as initial treatment for neonates with symptomatic congenital tracheal stenosis.

Abstract
Neonates with congenital tracheal stenosis (CTS) sometimes develop respiratory distress and may be difficult to intubate. We used balloon tracheoplasty with a rigid bronchoscope for emergency airway management in neonates with symptomatic CTS. Herein, we describe the balloon tracheoplasty procedure and the early outcomes following its use as the initial treatment of neonatal symptomatic CTS. We performed a retrospective analysis of five neonates with CTS who were initially treated with balloon tracheoplasty at our institution from January 2010 to December 2013. Five patients with a mean birthweight of 2,117 g were treated during the study period. Of these, four developed respiratory distress after birth, and all patients had difficult intubations. In all five patients, definitive diagnosis of CTS was made by rigid bronchoscopy and 3-dimensional reconstruction scan. A total of nine balloon dilatations were performed in five patients. Following balloon tracheoplasty, two patients were extubated, one was extubated after resection and end-to-end anastomosis following initial balloon dilatation, and one remained hospitalized with tracheostomy for tracheomalacia. The remaining patient died from tracheal bleeding associated with congenital heart disease. Although our sample size was small, balloon tracheoplasty is a potentially effective initial treatment for selected cases with neonatal symptomatic CTS.
AuthorsShigeru Ono, Kosaku Maeda, Katsuhisa Baba, Yoshiko Usui, Yuki Tsuji, Insu Kawahara, Atsuhisa Fukuta, Sachi Sekine
JournalPediatric surgery international (Pediatr Surg Int) Vol. 30 Issue 9 Pg. 957-60 (Sep 2014) ISSN: 1437-9813 [Electronic] Germany
PMID25064230 (Publication Type: Journal Article)
Topics
  • Bronchoscopy (methods)
  • Female
  • Humans
  • Imaging, Three-Dimensional (methods)
  • Infant
  • Infant, Newborn
  • Intubation (methods)
  • Male
  • Radiography
  • Retrospective Studies
  • Survival Analysis
  • Tracheal Stenosis (congenital, diagnostic imaging, therapy)
  • Treatment Outcome

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