Y-SHAPED TRACHEOBRONCHIAL STENT FOR CARINAL AND DISTAL TRACHEAL STENOSIS

A Y-shaped tracheo-bronchial tube was designed and used for two patien ts with carinal stenosis following a lower tracheal resection in one c ase and a malignant tracheal fistula in the other, The tube consisted of three parts including a Y-shaped, thin-walled, soft silicone stent; a spiral-wire-reinforced main tube; and a curved tracheostomy tube. T he stent was inserted easily and comfortably through the tracheostomy under fiberoptic bronchoscopic guidance with minimal local anesthesia. The positioning stability of the tube was excellent because of the ca rina-shaped structure of the tube end. Resistance to compression was s atisfactory due to the embedded spiral wire. The insertion procedure t hrough the tracheostomy was smooth, even in patients whose respiratory condition was severe or critical, Satisfactory phonational activity w as also provided by breathing through the hole on the tube back up to the vocal cord, Bronchoscopic inspection was uncomplicated, and the pa tients themselves could easily clean the stent. Since palliation of th e airway obstruction is the main purpose of such a stent for patients with either severe lower tracheal or carinal stenosis, and because of the difficulty of ordinary stent insertion in this part of the airway, this device appears to offer excellent stability and easy insertion o f the stent. In addition, the ease of maintenance and suctioning throu gh the tracheostomal end allows for an excellent quality of life in wh ich the patients are able to return to their homes.