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Transcervical Dumon Stenting via Longitudinal Tracheotomy for Recurrent Upper Tracheal Restenosis after Failed
1Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Abstract:
Post-tuberculosis airway stenosis can cause fixed cicatricial narrowing and long-term disability. We report a female patient with recurrent upper tracheal restenosis despite 2 prior resections, who presented decades later with respiratory failure; intubation was impossible, necessitating emergency tracheostomy. Imaging and bronchoscopy revealed pinhole stenosis near the second tracheal ring and left main bronchial stenosis with a destroyed left lung. The patient remained tracheostomy-dependent and aphonic after infection control. Because repeat resection was high-risk and endoscopic stent delivery was infeasible, a Dumon silicone stent was inserted via transcervical longitudinal tracheotomy under direct vision. Airway patency and phonation improved, and follow-up showed a stable stent without major complications. This open approach may serve as a salvage surgery when endoscopic delivery is impossible.
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