Dr Ameen

Ear, Nose & Throat Specialist KL

Medicine is our effort. Healing is God’s mercy

TRACOE Aeris balloon dilatation catheter

Balloon dilation (BD) was first introduced as a treatment option in 1984 for tracheal and bronchial stenoses. This procedure is suitable when the cartilaginous framework of the airway remains intact. Utilizing direct endoscopic guidance, a balloon is employed to exert radial pressure on the narrowed airway, aiming to minimize the likelihood of mucosal damage and subsequent restenosis.

Today, I will discuss a case involving a patient with grade 3 subglottic stenosis. This individual has a medical history that includes hemolymphatic malformation in the anterior chest wall and a mediastinal mass. Furthermore, previous attempts at extubation have been unsuccessful, resulting in the need for a tracheostomy, and multiple dilatation procedures have been performed to manage the subglottic stenosis.

Now, let’s delve into the details of the procedure:

Tracheostomy tube changed to a cuffed ones
Patient position pre direct laryngoscopy procedure
Protecting the lips and teeth from injury is paramount
Parsons laryngoscope application
Scope is stabilised with a rod
Sizing of the stenosis using ETT
Kenocort injection prepared and primed, butterfly needle 23G used
Injection in progress
Injection done at the stenotic part
Balloon catheter prepared
Balloon inserted and held in place to avoid watermelon seeding phenomenon
10ATM pressure applied for 2 minutes
Post dilatation view – dilatation repeated 3 times
100% success 😁
Pre assessment 62% obstruction
Post procedure sizing – stenosis improved to grade 1

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