Silicone stent placement using a rigid bronchoscope via a tracheostoma in a patient with postpneumonectomy syndrome

Silicone stents are options for airway stenosis or obstruction. Generally, silicone stent placement needs rigid bronchoscopy, but manipulation of a rigid bronchoscope has technical difficulties in some cases. The objective of this clinical case report is to highlight silicone stent placement with a rigid bronchoscope successfully achieved by changing the insertion from the mouth to the tracheostoma in a patient with postpneumonectomy syndrome.

A 47-year-old man underwent right-side pneumonectomy 30 years previously, and he had an intubation tube inserted through a tracheostoma for 29 years to maintain the lumen for bronchial stenosis due to postpneumonectomy syndrome. A granuloma grew at the distal end of intubation tube, and he had labored breathing with stridor. Rigid bronchoscopy for silicone stent placement via the mouth failed because of airway curvature. We sequentially tried rigid bronchoscopy via the tracheostoma as an alternative, and we could easily insert the scope into the left secondary carina and place the silicone stent.

Although strong airway curvature with tracheostomy is an uncommon situation, we succeeded silicone stent placement using a rigid bronchoscope via the tracheostoma. Insertion of a rigid bronchoscope via the tracheostoma instead of via the mouth could be an option.