Efficacy of transoral intraluminal wallstents for tracheal stenosis or tracheomalacia

Objectives: The efficacy and safety of intraluminal Wallstent Endoprosthesi s (Boston Scientific/Medi-Tech, Quincy, RIA) placement to restore airway pa tency in patients with tracheal stenosis or tracheomalacia are unknown. Stu dy Design: Retrospective review in setting of tertiary, referral, and acade mic center. Methods: A retrospective review of 13 consecutive patients over a 2-year period who underwent transoral resection of tracheal stenosis and immediate transoral Wallstent placement. One patient had tracheomalacia. A ll of the patients were considered at high risk for transcervical surgery o r had failed prior traditional open procedures, Results: The average patien t age was 54.2 years, with nine male and four female patients. All had Cott on/Myer stenoses (grades II to IV) with moderate to severe degrees of inspi ratory strider. Four patients were tracheotomy dependent. The length of ste nosis varied from 1 to 4 cm, One patient had a 10 cm segment of tracheomala cia, At the time of writing none of the patients has had a problem with sig nificant migration or extrusion and most of the patients have incorporated the stent well without any short-term obstructive granulation tissue. After a mean follow-up of 15 months (range, 4-24 mo). 10 of the 12 patients with stenosis (83%) have remained free of any inspiratory noise during breathin g. The one patient with tracheomalacia also has remained free of symptoms. Conclusions: Transoral Wallstents appear to be safe and may be a reasonable alternative in the restoration of airway patency in select patients with t racheal stenosis or tracheomalacia.