Successful Endoscopic Management of Complete Tracheal Occlusion in a Child

Area of Science:

• Pediatric Pulmonology
• Otolaryngology
• Interventional Bronchoscopy

Background:

• Prolonged mechanical ventilation often leads to tracheostomy, a procedure associated with late complications such as tracheal granulation.
• Tracheal granulation can cause significant airway obstruction, necessitating intervention.
• Current literature suggests surgical excision or endoluminal techniques for managing large granulation tissue.

Observation:

• A 6-year-old boy developed severe tracheal stenosis due to prolonged tracheostomy and endotracheal cuff injury.
• The patient presented with symptoms indicative of high-grade airway compromise.
• Standard treatment options were considered but an alternative approach was pursued.

Findings:

• An unconventional, multi-stage endoscopic approach was employed for management.
• The treatment involved repeated sessions of rigid bronchoscopic dilation.
• Endoluminal cryotherapy was utilized as an adjunct to dilation.

Implications:

• This case demonstrates the successful application of combined endoscopic rigid bronchoscopic dilation and cryotherapy for tracheal granulation in a pediatric patient.
• The findings suggest this minimally invasive technique may be a viable alternative to surgical excision for selected cases.
• Further research is warranted to establish the long-term efficacy and safety of this combined approach in managing pediatric tracheal stenosis.