Balloon Dilatation Using Flexible Bronchoscopy For The Management Of Benign Tracheobronchial Stenosis

Objective To assess the efficacy and safety of balloon dilatation using a flexible bronchoscope in the management of benign tracheobronchial stenosis.Methods 14 cases with benign tracheobronchial stenosis (TBS) underwent balloon dilation through flexible bronchoscopy under topical anesthesia. 21 constrictive sites were dilated. There were four men and ten women with ages ranging from 16 to 52 years (mean 32.4±10.1 years), whose symptoms of dyspnea, cough, or wheeze were attributable to a TBS. The indications were post-tuberculous bronchostenosis (n = 11), congenital stenosis (n = 1), tacheobronchial amyloidosis (n = 1) and bronchial trauma (n = 1). A flexible guidewire was inserted through the working cannel of bronchoscope and passed through the lesion. The balloon catheter was introduced over the wire, correctly positioned across the stenosis. Under direct visualization, the balloon was inflated for 30s to 180s without fluoroscopic guidance. Repeat inflation-deflation cycles were done if airway narrowing remained after the initial attempt. Airway diameters, dyspnea index and complications were evaluated in all patients and lung function studies including FEV₁, PEF, FVC, MVV were tested within 3 d before and after management. Patients were followed for 1 to 18 months(mean, 8.00 ± 5.09 months).Results A total of 29 balloon dilation sessions were performed in 14 patients with a range of one to five sessions per patient (mean, 2.07±1.38 sessions).After balloon dilation,airway average diameter increased from (4.14 ± 2.09)mm to (9.54 ± 2.06)mm (P<0.01). Dyspnea index decreased from 2.07 ± 0.82 to 0.74±0.49 (P<0.01). 11 patients had 18 constrictive sites due to tuberculosis , required a 1～4...