PMC2820441_01
Sagittal and coronal view of the CT scan showing a short segment stenosis just above the tracheostomy.
1757-1626-3-2-1.jpg
PMC2820441_01_1757-1626-3-2-1.jpg
F1
A neck CT scan confirmed the presence of a short segment tracheal stenosis (less than 1 cm) [figure 1].
A pledget soaked with Mitomycin C applied via rigid forceps to the stenotic area.
1757-1626-3-2-2.jpg
PMC2820441_01_1757-1626-3-2-2.jpg
F2
Pledgets soaked with diluted Mitomycin C (concentration 0.2 mg/ml) were introduced using rigid forceps through the rigid bronchoscope to the raw surface of the mucosa and direct pressure applied via the rigid forceps [figure 2].
The appearance of the stenotic area immediately after application of Mitomycin C.
1757-1626-3-2-3.jpg
PMC2820441_01_1757-1626-3-2-3.jpg
F3
A total of 4 applications or 8 minutes of contact time was needed [figure 3].
The appearance of the stenotic area 2 weeks after the procedure.
1757-1626-3-2-4.jpg
PMC2820441_01_1757-1626-3-2-4.jpg
F4
At 2 weeks, a flexible bronchoscopy showed a patent airway and she was weaned off the tracheostomy tube after she tolerated spigotting for 48 hours [figure 4].
The appearance of the stenotic area after one month: Noted there was a small granulation tissue over the anterior surface of the mucosa, but a flexible bronchoscope could still be passed through easily.
1757-1626-3-2-5.jpg
PMC2820441_01_1757-1626-3-2-5.jpg
F5
Repeat flexible bronchoscopy was done at 1 month [figure 5] and then 4 month [figure 6] after the procedure.
The appearance of the stenotic area after 4 months: Noted the granulation tissue was still present but not enlarging and a flexible bronchoscope could still be passed through easily.
1757-1626-3-2-6.jpg
PMC2820441_01_1757-1626-3-2-6.jpg
F6
Repeat flexible bronchoscopy was done at 1 month [figure 5] and then 4 month [figure 6] after the procedure.