11/09/2026
🔴 **When there is no visible airway lumen… you have to create one.**
A challenging case of **severe post-intubation tracheal stenosis following prolonged mechanical ventilation** managed in our **Pulmonology and Interventional Bronchoscopy Unit, Ain Shams University Hospitals**.
The patient initially underwent balloon dilatation, followed by resection of five tracheal rings with cricotracheal anastomosis. The postoperative course was complicated by anastomotic disruption, recurrent stenosis, and ultimately tracheostomy.
The patient was later referred to our unit with severe dyspnea for possible airway stenting.
🔹 Upon introduction of the rigid bronchoscope, the tracheal lumen was almost completely obliterated by dense cicatricial tissue with an irregular soft-tissue component, with no clearly identifiable airway track. Even a forceps or suction catheter could not identify a passage toward the distal trachea.
Using the tracheostomy tube as an anatomical guide, electrocautery was carefully applied to the center of the obstruction, followed by mechanical debulking, successfully creating an initial airway lumen.
Progressive dilatation with the rigid bronchoscope was then performed, followed by deployment of a **12 × 7 cm silicon tracheal stent**.
✨ **Excellent stent expansion and wall apposition, restoration of airway patency, and marked improvement in dyspnea.**
**A difficult airway demands precision, patience, and a stepwise approach.**
📍 **Bronchoscopy and interventional pulmonology Unit
Ain Shams University Hospitals**
