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Case reports

When parents opted not to perform surgery for a long-segment congenital tracheal stenosis child: flexible bronchoscopic balloon tracheoplasty as the primary treatment

Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan

Received 6 February 2009; received in revised form 26 February 2009; accepted 10 March 2009.

^_* Corresponding author. Address: Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung Medical Center, #123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan. Tel.: +886 7 731 7123x8703; fax: +886 7 731 2867. (Email: niusnet{at}ms10.hinet.net).

Congenital tracheal stenosis is a rare airway disorder characterized by a fixed tracheal narrowing. Surgical intervention is usually considered as the treatment of choice for long-segment type. However, due to wide spectrum of this disease, treatment modalities need to be individualized. The long-segment type has the most unfavorable outcome because it is often associated with multiple anomalies and, thus, the most difficult to manage. Here we present a case of long-segment congenital tracheal stenosis (LSCTS) that was managed by several sessions of flexible bronchoscopic balloon tracheoplasty as the primary treatment. In this particular situation, we had to deal with the parents’ request of a ‘non-surgical’ approach for an infant who had respiratory distress that also required a way to increase his tracheal diameter simultaneously. Having done this particular experience, we would like to show that this non-surgical approach can be viable for long-segment tracheal stenosis in selected cases.

Key Words: Congenital tracheal stenosis • Balloon dilatation • Flexible bronchoscopy • Tracheoplasty • Congenital anomalies • Endoscopy