Resolution of Distal Tracheal Obstruction Using Endoscopic-Guided Holmium:Yttrium-Aluminium-Garnet Laser Ablation in...

A 2-year-old, female, blue and gold macaw (Ara ararauna) presented with respiratory distress following a 1-week history of altered vocalization. The bird was anesthetized for a computed tomography scan, air sac cannulation, and tracheoscopy. The bird was diagnosed with a distal tracheal obstruction, occupying more than 80% of the tracheal lumen. Initial attempts at biopsy and resection were unsuccessful because of limited access to the obstruction. The bird was managed medically for 1 week with a combination of an oral antifungal medication, antibiotic drugs, a nonsteroidal anti-inflammatory agent, and daily intratracheal antifungal therapy. Tracheal endoscopic-guided Holmium:yttrium-aluminium-garnet laser ablation of the tracheal lesion allowed for complete removal of the mass, and the bird could vocalize within a few days of the procedure. On repeat tracheoscopy and computed tomographic examination 6 weeks postlaser ablation, there was no evidence of inflammation, recurrence of the mass, or stricture formation. Holmium:yttrium-aluminium-garnet laser ablation may be a valuable and minimally invasive tool for managing tracheal obstructions such as tracheal granulomas and strictures in birds.