All issues > Volume 48(5); 2005

Original Article

Korean J Pediatr. 2005;48(5):512-517. Published online May 15, 2005.

Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis

Ju Young JY Jang¹, Hyo-Bin HB Kim¹, So Yeon SY Lee¹, Ja Hyung JH Kim¹, Seong Jong SJ Park¹, Ji Hoon JH Shin², Soo-Jong SJ Hong¹

¹Department of Pediatrics, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea
²Department of Diagnostic Radiology, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea

Correspondence Soo-Jong SJ Hong ,Email: sjhong@amc.seoul.kr

Abstract

Purpose
: In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents.
Methods
: Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent.
Results
: The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent.
Conclusion
: We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children

Keywords :Children , Airway obstruction , Airway stent , Tracheal stenosis , Bronchomalacia , Endotracheal tuberculosis