Paediatric airway stenting: An endoscopic approach to the management of severe airway obstruction

Airway stenting is a complex bronchoscopic intervention that is infrequently performed in children due to limited training opportunities and a lack of appropriate paediatric equipment. We present our institutional data on children (<18 years) who underwent airway stent placement for various tracheobronchial pathologies.

We conducted a retrospective study of children with notable airway anomalies who underwent stent placement at our institute over a 3.5-year period (January 1, 2020, to June 30, 2023). Data collected included patient age, type and severity of airway obstruction, clinical condition at presentation, type of stent used, complications, outcomes, and follow-up findings.

During the study period, 13 stents were deployed in 12 children with tracheobronchial obstruction. Indications for stenting included severe airway stenosis, airway malacia, stenosis with malacia, and tracheoesophageal fistula (TEF). Stent selection depended on age, lesion location, and device availability. No procedure-related mortalities were noted. The most common complication was granulation tissue formation. After an average 10-month follow-up, 85.7% were clinically stable following stent removal.

Although limited by sample size, our findings support the safety and efficacy of airway stenting in children with tracheobronchial obstruction. Stenting serves as a suitable therapeutic choice when conventional approaches have been unsuccessful or are not suitable. Therefore, it is crucial to establish a robust follow-up system to promptly address any potential complications.