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Controlling difficult airway by rigid bronchoscope—an old but effective method

Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kweishan, Taoyuan, Taiwan

*Corresponding author. Tel.: +886-3-3281200, ext. 2118; fax: +886-3-3285818.

E-mail address: pjko{at}cgmh.org.tw (P.-J. Ko).

Managing the airway of patients with critical tracheal stenosis remains a formidable challenge to surgeons and anesthiologists. Various methods for controlling the airway have been established to solve this problem. This study describes the critical tracheal stenosis is managed by dilating and coring technique under direct vision with a rigid bronchoscope. From 2001 to 2003, 34 patients (23 males/11 females) with critical tracheal stenosis (>90%) underwent 37 surgical interventions. The etiologies included 8 cases of post-intubation, 7 cases of post-tracheostomy, 5 cases of post-anastomotic, 14 cases of endotracheal tumor (4 primary, 10 secondary), and 3 cases (1 tuberculosis, 1 laser burn, and 1 idiopathic) of other etiologies. All procedures could achieve airway control with rigid bronchoscope. Other endoscopic procedures (laser, and stent placement) were required to achieve a patent airway and seven patients received airway reconstruction as a definite procedure. Rigid bronchoscopy could provide good results for controlling airway in patients with critical trachea stenosis.

Key Words: Critical tracheal stenosis; Rigid bronchoscopy; Difficult airway

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