• Journal of Veterinary Clinics
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• v.39 no.2
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• pp.87-92
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• 2022

A 14-year-old castrated male Persian cat presented with a 2-week history of respiratory difficulty. On physical examination, the patient showed intermittent open-mouth breathing and thoracic auscultation revealed wheezing. Thoracic radiographs revealed a narrowed upper airway and pulmonary infiltration. Computed tomography detected a mass occluding the lumen of the trachea at the level of the entrance to the thorax, a mass causing right main bronchus stenosis, and a nodule on the right caudal lung lobe. Bronchoalveolar lavage cytology tentatively diagnosed a carcinoma. Tracheal mass resection was performed through tracheostomy. Histopathology confirmed the presence of tracheobronchial carcinoma. The survival time after diagnosis was 10 months, during which time the cat underwent tracheostomy, debulking by endotracheal tube, and tracheal stent placement procedures in combination with toceranib phosphate adjuvant chemotherapy.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.450-456
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• 2002

Idiopathic tracheal stenosis is a type of benign stenosis that possesses specific characteristics but is of unknown origin. It is a rare disease characterized by extensive fibrosis of a portion of trachea, and predominantly found in women. The lesion presents as circumferential fibrotic stenosis that usually occurs at upper trachea and the subglottic larynx, but lower trachea may also be involved. Diagnosis is made from the clinical characteristics accompanide by compatible pathologic features and by exclusion of other etiologies. Conservative management such as laser resection, dilatation and stent insertion can be tried initially, but surgical resection is recommended for definitive treatment due to frequent restenosis and maintenance problems of conservative approach. We report a case of idiopathic tracheal stenosis treated with tracheal resection and anastomosis followed by insertion of a retrievable stent for immediate relief of airway obstruction.

• Tuberculosis and Respiratory Diseases
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• v.74 no.5
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• pp.226-230
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• 2013

Fetal adenocarcinoma is a rare adenocarcinoma subtype of pulmonary blastoma. A 48-year-old male patient is being referred to our hospital due to progressive dyspnea. A chest X-ray showed a lung mass of unknown origin that was obstructing the right main bronchus. After relieving the airway obstruction with stent insertion via bronchoscopy, a diagnosis of fetal adenocarcinoma is being confirmed through thoracoscopic biopsy. Due to the locally advanced state of the lung cancer, it seemed to be inoperable, and concurrent chemo-radiation therapy was being administered with docetaxel. The stent was removed after improvements in the airway obstruction followed by a lung mass shrinkage. Comparing to other contexts which describe fetal adenocarcinoma as lower grade malignancy with low-associated mortality, herein, we describe a case of locally-advanced fetal adenocarcinoma (T4N3M0). This is the first documented case being treated with concurrent chemoradiation therapy. The followed-up image studies represent a partial response and the patient is currently under further observations.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.416-420
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• 1998

Flow-volume loop is known to be useful in the diagnosis of upper airway obstruction. In cases of tracheal obstruction, characteristic features such as fixed or variable upper airway obstruction patterns give clue to the diagnosis. But the flow-volume loop of unilateral mainstem bronchial stenosis is not known well. There is controversy in patterns of flow-volume loop in unilateral mainstem bronchial stenosis (restrictive pattern or biphasic pattern). We report a case of biphasic flow-volume loop in left mainstem bronchial stenosis(4-5 mm in diameter) as a sequela of endobronchial tuberculosis, which recovered normal flow-volume loop after metallic stent insertion and 2 months later showed reappearance of biphasic pattern because of restenosis of left mainstem bronchus due to growth of granulation tissue at the stent site.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.431-438
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• 2002

Background : In order to investigate the usefulness and safety of Natural Stent, we performed this study in a canine model of tracheal stenosis induced using Nd-YAG laser. Materials and Methods : After tracheal stenosis was induced in 12 Mongrel dogs using Nd-YAG laser, either Dumon (n=6) or Natural (n=6) stent was inserted into the trachea. To assess the degree of stent migration and mucostasis, bronchoscopy was performed every week for 4 weeks, after which all stents were removed. One week after stent removal, tracheal stenosis was evaluated by bronchoscopy. Results : The degree of stent migration was not different between the dogs with Dumon stent ($3.0{\pm}0.8$) and those with Natural ($2.0{\pm}1.0$), nor was the degree of mucostasis, at Dumon ($1.7{\pm}0.5$) and Natural Stent ($1.5{\pm}0.6$), respectively. One week after stent removal, the degree of tracheal stenosis was not different between the Dumon ($1.5{\pm}0.5$) and the Natural group ($1.0{\pm}0.4$). In addition, there was no death and the degree of tracheal stenosis remained always within the safe limit (less than 2.0) in all animals. Conclusion : In a canine model of tracheal stenosis induced using Nd-YAG laser, the usefulness and safety of Natural Stent were similar to those of Dumon Stent. A clinical trial is necessary to document the usefulness and safety of Natural Stent in patients with tracheal stenosis.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.129-135
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• 1995

The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.

• Korean Journal of Bronchoesophagology
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• v.13 no.1
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• pp.51-54
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• 2007

Laryngeal trauma is an uncommon injury but can be life-threatening event. So, early diagnosis is important for appropriate surgical management and better outcome. Because there have been some controversies about Initial airway management, appropriate diagnostic evaluation, operative indication and timing, operative technique, it is difficult to make a common management pathway in laryngeal trauma. A case of laryngeal trauma with thyroid cartilage and hyoid bone fracture is presented with a brief review of literature.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.182-190
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• 1999

OBJECTIVES : To determine the results of posterior cricoid split with costal cartilage graft in the treatment of moderate and severe subglottic stenosis in adults, and to assess the effect of T-tube as a stent in this surgery. PATIENTS AND METHODS : Four adults with moderate and severe subglottic stenosis who underwent posterior cricoid split with costal cartilage graft from 1994 to 1995. Three patients were male and one was female. All of the patients had acquired subglottic stenosis, 2 of whom had a bilateral vocal folds paralysis. The surgical procedure we used included a cricoid lamina split with costal cartilage grafting and T-tube stenting. Arytenoidectomy was a added in 2 patients with bilateral vocal folds paralysis. RESULTS : Three of the 4 patients underwent decannulation, and 1 is still undergoing treatment. 3 patients who underwent decannulation demonstrated marked improvement in their symptoms of airway obstruction and good postoperative voice quality. CONCLUSIONS : The posterior cricoidotomy lumen augmentation with costal cartilage grafting is a safe and effective technique for the treatment of moderate and severe subglottic stenosis in adults and T-tube is a good alternative stenting material for this procedure.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.353-358
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• 2001

Relapsing polychondritis (RP) is rare, chronic, relapsing, and multisystemic inflammatory disease targeting the cartilaginous structures. Respiratory track involvement occurs in approximately half of the cases. Subglottic stenosis is a rare manifestation of RP. Here, we report a case of RP with a subglottic stenosis, resulting in acute respiratory failure. A 63-year old man was admitted complaining of multiple joint pain, general weakness, weight loss, throat pain, hoarseness, exertional dyspnea, and hearing difficulties. A laryngoscopy and neck CT revealed a subglottic stenosis. Four days after admission, he complained severe dyspnea resulting in acute respiratory failure. Immediately, a tracheostomy was done for airway preservation. After high dose steroid therapy, the general symptoms were improved. However, the subglottic stenosis was sustained. Thus, a laryngotracheal augumentation and stent insertion was performed. The speech valve was then replaced. The subglottic stenosis was managed with low dose steroid and monthly cyclophosphamide pulse therapy, and the patient has been followed up regularly.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.494-503
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• 1994

Background: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic stent, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. Method: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-Y AG) laser through a flexible bronchoscopy. Results: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. Conclusion: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.