Conservative surgical management of tracheal stenosis

Tracheal stenosis has become an increasing complication following tracheostomy or prolonged intubation for mechanical ventilation and is directly related to trauma. Tracheal resection up to 4 to 5 cm with end-to-end anastomosis is the generally accepted treatment. However, tracheal resection carries mortality and considerable morbidity. From 1974 to 1977 all patients seen with tracheal stenosis, regardless of the etiology and age, were initially treated with a conserative surgical management. It consists of dilation, severance of the stenotic ring, intralesional injection of triamcinolone acetonide, and stenting with a silicone T tube for 90 days. Nine out of 11 patients had good results and enjoy an adequate airway without a tracheostomy tube. The longest follow-up is three years and the shortest is eight months. Intralesional injection of triamcinolone acetonide is essential for a successful treatment. No serious complications due to this treatment have occurred. This technique appears worthy of trial prior to contemplating a more extensive procedure.