Palliative Therapy with Argon Plasma Coagulation in Post-Intubation Tracheal Stenosis

Post-intubation tracheal stenosis is usually caused by pressure necrosis at the cuff. Although the best results are obtained by tracheal reconstruction, not all patients are able to undergo this operation for either medical or personal reasons. A 67-year-old male was admitted to our hospital with progressive dyspnea unrelieved by medical management. Bronchoscopy revealed stenosis of the trachea 2 cm below the vocal cord. In this case, as respiratory failure accompanied by COPD constituted a contraindication for tracheal surgery. It was decided to dilate the tracheal stenosis with APC. A 20-year-old female was admitted to our hospital with dyspnea and stridor. Bronchoscopy revealed a stenosis of the trachea 3 cm below the vocal cord. Because surgery was refused it was decided to dilate the tracheal stenosis with APC. APC has been successfully employed in the treatment of post-intubation tracheal stenosis in two surgery-refused and inoperable patients. The patients immediately experienced a relief of symptoms after APC. APC appears to be an effective alternative procedure for endobronchial dilatation in selected patients who are inoperable for either medical or personal reasons.