Endoscopically placed expandable metal tracheal stents for the management of complicated tracheal stenosis☆

Background: Metal stents have been advocated to manage complicated tracheal stenosis. Objective: The purpose of this investigation is to review the effectiveness of endoscopic placement of tracheal expandable metal stents for complicated tracheal stenosis. Methods: The charts of 6 patients who have undergone placement of metal expandable stents between 1998 and 2000 were reviewed. Results: Initially, all patients enjoyed immediate palliation of symptomatic tracheal stenosis. Eventually, 4 patients developed significant granulation tissue and/or recurrent stenosis, requiring intervention within 6 months after placement of the stent. One patient required the removal of the stent and placement of a T-tube silicone stent. Conclusions: Metal stents provide temporary palliation for tracheal stenosis. Metal stents, however, are associated with a high incidence of obstruction with granulation tissue. Their use should be limited to a select group of patients with a short life expectancy (because of other comorbidities) or patients who are not good candidates for reconstructive surgery and/or who refuse or cannot tolerate a tracheotomy. (Am J Otolaryngol 2003;24:34-40. Copyright 2003, Elsevier Science (USA). All rights reserved.)