Interventional Treatment For Tuberculous Airway Stenosis

OBJECTIVES: To investigate the methods and efficacy of interventional treatment for tuberculous stenosis.METHODS: To retrospectively analyze the clinical data of 17 patients with tuberculous airway stenosis who were hospitalized at the depart ment of respiratory, the first affiliated hospital of Guangxi medical university from December 2006 to December 2008.RESULTS: Seventeen patients with tuberculous steno-sis were treated by intentional methods (including high-frequency electric cautery and balloon dilation or stent implantation), and also treated with multiple drug chemotherapy protocol (2HRZE/7HR) and inhaled with isoniazid and budesonide aerosol. One of the patients with inflammatory infiltration and ulcer-type necrosis endobron- chial tuberculosis was alone cured by inhalation with isoniazid and budesonide aerosol without interventional therapy, other patients were improved for clinical symptoms with their bronchial lumen increase after bronchofibroscope review, and they were discharged without serious complications. With 4-18 months follow-up, 14 of 17patients recovered from their airway stenosis, but three of them couldn't keep their airway opening. One patient, who was diagnosed as bronchomalacia after balloon dilatation, had to do operation later. Two of the patients were of recurrent granulation tissue formation after the stent placement three months, one of them was controlled in good condition with high frequency electric cautery treatment, and serious hemoptysis happened to another patient during the electric cautery treatment for airway reopening.CONCLUSIONS: It is effective and safe for tuberculous airway stenosis treated with high-frequency electric cautery and tracheal balloon dilation, especially for the patients with stable endobronchial tuberculosis .It is also more effective for active endobronchial tuberculosis lesion with budesonide aerosol and isoniazid inhalation.