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Y. Jacobo Nurko - One of the best experts on this subject based on the ideXlab platform.
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Efficacy of transoral intraluminal Wallstents for tracheal stenosis or Tracheomalacia.
The Laryngoscope, 2000Co-Authors: Roy R. Casiano, William A. Numa, Y. Jacobo NurkoAbstract:Objectives The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/Medi-Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or Tracheomalacia are unknown. Study Design Retrospective review in setting of tertiary, referral, and academic 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. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures. Results The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10-cm segment of Tracheomalacia. At the time of writing, none of the patients has had a problem with significant 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 breathing. 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 tracheal stenosis or Tracheomalacia.
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Efficacy of transoral intraluminal Wallstents for tracheal stenosis or Tracheomalacia.
The Laryngoscope, 2000Co-Authors: Roy R. Casiano, William A. Numa, Y. Jacobo NurkoAbstract:The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/ Medi-Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or Tracheomalacia are unknown. Retrospective review in setting of tertiary, referral, and academic center. 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. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures. The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10-cm segment of Tracheomalacia. At the time of writing, none of the patients has had a problem with significant 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 breathing. The one patient with Tracheomalacia also has remained free of symptoms. Transoral Wallstents appear to be safe and may be a reasonable alternative in the restoration of airway patency in select patients with tracheal stenosis or Tracheomalacia.
Roy R. Casiano - One of the best experts on this subject based on the ideXlab platform.
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Efficacy of transoral intraluminal Wallstents for tracheal stenosis or Tracheomalacia.
The Laryngoscope, 2000Co-Authors: Roy R. Casiano, William A. Numa, Y. Jacobo NurkoAbstract:Objectives The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/Medi-Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or Tracheomalacia are unknown. Study Design Retrospective review in setting of tertiary, referral, and academic 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. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures. Results The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10-cm segment of Tracheomalacia. At the time of writing, none of the patients has had a problem with significant 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 breathing. 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 tracheal stenosis or Tracheomalacia.
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Efficacy of transoral intraluminal Wallstents for tracheal stenosis or Tracheomalacia.
The Laryngoscope, 2000Co-Authors: Roy R. Casiano, William A. Numa, Y. Jacobo NurkoAbstract:The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/ Medi-Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or Tracheomalacia are unknown. Retrospective review in setting of tertiary, referral, and academic center. 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. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures. The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10-cm segment of Tracheomalacia. At the time of writing, none of the patients has had a problem with significant 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 breathing. The one patient with Tracheomalacia also has remained free of symptoms. Transoral Wallstents appear to be safe and may be a reasonable alternative in the restoration of airway patency in select patients with tracheal stenosis or Tracheomalacia.
Toshihiro Muraji - One of the best experts on this subject based on the ideXlab platform.
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surgical strategy for acquired Tracheomalacia due to innominate artery compression of the trachea
European Journal of Cardio-Thoracic Surgery, 2011Co-Authors: Yukihiro Tatekawa, Toshihiro MurajiAbstract:We reviewed six cases demonstrating acquired Tracheomalacia due to innominate artery compression of the trachea and investigated the benefit and effectiveness of a technique for correcting Tracheomalacia. All the patients developed scoliosis and the innominate artery run over the trachea. Four cases had permanent neurologic impairment, whereas two patients developed acquired neurologic impairment. The surgical strategy for acquired Tracheomalacia due to innominate artery compression of the trachea involved superior mediastinal exposure, external reinforcement with autologous cartilage graft, anterior sling of the innominate artery with a muscle sling, and tracheopexy. Our surgical procedure has been effective in maintaining the patency of the tracheal lumen in all cases but one. This patient suffered from straight back syndrome and developed recurrence of Tracheomalacia owing to mucosal infolding secondary to the deformed spine in a supine position. The authors believe our surgical procedure is effective to relieve the symptoms of Tracheomalacia, but it is important to select surgical interventions in accordance with the specific patient's condition.
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Surgical strategy for acquired Tracheomalacia due to innominate artery compression of the trachea.
European Journal of Cardio-Thoracic Surgery, 2010Co-Authors: Yukihiro Tatekawa, Toshihiro MurajiAbstract:We reviewed six cases demonstrating acquired Tracheomalacia due to innominate artery compression of the trachea and investigated the benefit and effectiveness of a technique for correcting Tracheomalacia. All the patients developed scoliosis and the innominate artery run over the trachea. Four cases had permanent neurologic impairment, whereas two patients developed acquired neurologic impairment. The surgical strategy for acquired Tracheomalacia due to innominate artery compression of the trachea involved superior mediastinal exposure, external reinforcement with autologous cartilage graft, anterior sling of the innominate artery with a muscle sling, and tracheopexy. Our surgical procedure has been effective in maintaining the patency of the tracheal lumen in all cases but one. This patient suffered from straight back syndrome and developed recurrence of Tracheomalacia owing to mucosal infolding secondary to the deformed spine in a supine position. The authors believe our surgical procedure is effective to relieve the symptoms of Tracheomalacia, but it is important to select surgical interventions in accordance with the specific patient’s condition. # 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Christopher J. Hartnick - One of the best experts on this subject based on the ideXlab platform.
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Preclinical assessment of resorbable silk splints for the treatment of pediatric Tracheomalacia.
Laryngoscope, 2018Co-Authors: Meghan Mcgill, Nikhila Raol, Kevin S. Gipson, Sarah N. Bowe, Jackson Fulk‐logan, Anahita Nourmahnad, Joon Yong Chung, Michael J. Whalen, David L. Kaplan, Christopher J. HartnickAbstract:OBJECTIVE Tracheomalacia is characterized by weakness of the tracheal wall resulting in dynamic airway collapse during respiration; severe cases often require surgical intervention. Off-label external splinting with degradable implants has been reported in humans; however, there remains a need to develop splints with tunable mechanical properties and degradation profiles for the pediatric population. The objective of this pilot study is to assess the safety and efficacy of silk fibroin-based splints in a clinically relevant preclinical model of Tracheomalacia. METHODS Silk splints were evaluated in a surgically induced model of severe Tracheomalacia in N = 3 New Zealand white rabbits for 17, 24, and 31 days. An image-based assay was developed to quantify the dynamic change in airway area during spontaneous respiration, and histopathology was used to study the surrounding tissue response. RESULTS The average change in area in the native trachea was 23% during spontaneous respiration; surgically induced Tracheomalacia resulted in a significant increase to 86% (P
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An Analysis of Children with Tracheomalacia Treated With Ipratropium Bromide (Atrovent)
The Laryngoscope, 2011Co-Authors: Thomas Gallagher, Steve Maturo, Shannon Fracchia, Christopher J. HartnickAbstract:Results: Complete data was available for 52 children diagnosed with Tracheomalacia and treated with ipratropium bromide after having been referred for specialist care for symptoms that were severe enough to warrant bronchoscopy or for symptoms that were refractory to prior medical therapy. Mild Tracheomalacia was diagnosed in 34 (65.3%) children while moderate Tracheomalacia was seen in 18 (34.7%). Overall 32 (61.5%) children had improvement in their symptoms following treatment with ipratropium bromide.
William A. Numa - One of the best experts on this subject based on the ideXlab platform.
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Efficacy of transoral intraluminal Wallstents for tracheal stenosis or Tracheomalacia.
The Laryngoscope, 2000Co-Authors: Roy R. Casiano, William A. Numa, Y. Jacobo NurkoAbstract:Objectives The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/Medi-Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or Tracheomalacia are unknown. Study Design Retrospective review in setting of tertiary, referral, and academic 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. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures. Results The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10-cm segment of Tracheomalacia. At the time of writing, none of the patients has had a problem with significant 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 breathing. 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 tracheal stenosis or Tracheomalacia.
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Efficacy of transoral intraluminal Wallstents for tracheal stenosis or Tracheomalacia.
The Laryngoscope, 2000Co-Authors: Roy R. Casiano, William A. Numa, Y. Jacobo NurkoAbstract:The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/ Medi-Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or Tracheomalacia are unknown. Retrospective review in setting of tertiary, referral, and academic center. 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. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures. The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10-cm segment of Tracheomalacia. At the time of writing, none of the patients has had a problem with significant 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 breathing. The one patient with Tracheomalacia also has remained free of symptoms. Transoral Wallstents appear to be safe and may be a reasonable alternative in the restoration of airway patency in select patients with tracheal stenosis or Tracheomalacia.
