TRACHEOBRONCHOGRAPHY AND BALLOON DILATATION IN ACQUIRED NEONATAL TRACHEAL STENOSIS

Between 1988 and 1992, 18 mechanically ventilated newborn babies (mean weight 1300 g and gestational age 30 weeks) presented with deteriorat ing respiratory failure at a mean age of 29 days. All developed increa sed oxygen requirements, hypoxic and hypercapnic episodes, and radiolo gical changes of fixed lobar emphysema or recurrent atelectasis which sometimes changed sides from one day to another. Tracheobronchography with iopydol-iopydone was normal in five (27%) cases, but in 13 showed tracheobronchial stenosis localised to the lower trachea (seven cases ), to the right main bronchus (three cases), or including the left mai n bronchus (four cases). Eleven of these 13 patients underwent endosco py and balloon dilatation of the stenotic area. Five patients died, on e before endoscopy, one immediately after endoscopies, and three subse quently with severe bronchopulmonary dysplasia. The other six babies r ecovered without any sequelae after balloon dilatation.