Management of subglottic stenosis with endoscopic stent placementVideo Type: CVideo
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Author: Henri Traboulsi
Specialties: Laryngology, Otolaryngology, Paediatric Airway, Pediatric Otolaryngology
Schools: Baylor College of Medicine, Texas Children's Hospital
History of airway stenosis, s/p laryngotracheal reconstruction. Developed restenosis, and balloon dilated three times.
In this video we describe our technique for airway stent insertion and its securing to the neck skin.
Balloon dilation of the airway expanded the airway to its appropriate size. After sizing, an 8mm modified Mehta laryngeal stent with rings (Hood Laboratories, Pembroke, Mass., USA)is inserted in the airway with laryngeal forceps. The scope is inserted into the stent to verify its position. Then a 2.0 prolene stitch is taken through the neck, trachea, stent, and taken out through the contralateral skin. This is performed under visualization with a 2.3mm endoscope through the stent. The needle is then re-inserted through the exit puncture and again taken out next to the entry puncture after passing through a subcutaneous tunnel, without re-entering the stent. A small skin incision is performed between the two prolene threads. Multiple knots are taken over an angiocath, which is then buried under the skin.
The stent is taken out 2-6 weeks after the procedure. A neck incision is performed, the angiocath is identified, the knot is cut and the stent is removed under the vision of the endoscope.