PMC9892195_01
The pathological anatomy view of the trachea under bronchoscopy. (a) Fistula in the upper membranous wall; (b) the constricted trachea.
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F1
A rigid bronchoscope (RB) was inserted to examine the tracheal status, including the fistula and the stent, confirming that the fistula was in the upper membranous tracheal wall (Figure 1). The metal stent beneath the fistula had undergone deformity, and the trachea beneath the fistula was constricted (Figure 1).
Pattern diagram of supraglottic jet oxygenation and ventilation (SJOV) via nasopharyngeal airway (NPA).
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F2
Thus, we developed the idea of tubeless ventilation that we called SJOV (Figure 2).
The deformed stent (a) and the covered metal stent mended the fistula and expanded the constricted trachea (b).
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F3
A covered metal stent (18 x 60 mm) was successfully placed to mend the tracheal fistula and expand the constricted trachea (Figure 3).