BALLOON DILATION OF CONGENITAL AND ACQUIRED STENOSIS OF THE TRACHEA AND BRONCHI

PURPOSE: To document the results of balloon dilation of the trachea an d bronchi in infants and children with congenital and acquired stenosi s. MATERIALS AND METHODS: Balloon dilation of congenital and acquired tracheal and bronchial stenosis was performed in six patients aged 5 w eeks to 2 years 8 months (mean, 12.5 months). Bronchography with nonio nic water-soluble contrast medium was performed initially through an e ndotracheal or tracheostomy tube with the patient sedated or under gen eral anesthesia. Balloon size (2-8 mm) was determined on the basis of diameter of the airway lumen distal to the stenosis measured at bronch oscopy. Twenty-three incremental balloon dilation procedures were perf ormed in these six patients at time intervals from 3 days to 2 years. Usually, three balloon insufflations were performed for 20-45 seconds at 4-6 atm during each procedure. RESULTS: Symptomatic improvement or increased lumen diameter occurred in four of six patients after balloo n dilation. No improvement was seen in two patients: One had unrecogni zed vascular compression of the proximal left bronchus and distal trac hea, and the other, of the left upper lobe bronchus. There were no com plications. CONCLUSION Balloon dilation was a safe and effective palli ative procedure for treatment of congenital and acquired stenosis of t he trachea and bronchi. Symptomatic improvement and increased lumen di ameter occurred but may be temporary. Performance of serial dilation p rocedures was necessary to effect a long-term cure.