Dilatation of a tracheal web
by Philippe Monnier T, Philippe Vicky S, Philippe Bachi T

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates the use of a CO2 LASER for dilatation of a tracheal web. The procedure is based on the mucosa-sparing technique, wherein radial incisions are made using the CO2 LASER leaving behind islands of mucosa in between the incisions. This is followed by dilatation using gum elastic bougies. The islands of mucosa left behind help to promote rapid epithelialization and prevent restenosis. It is important to select the patients for this procedure as well as only patients with a membrane-like partial stenosis, that does not involve the tracheal cartilages, should be dilated in such a manner. Any stenosis that has involved the tracheal cartilages should be dealt with by an open technique such as a tracheoplasty or a resection-anastomosis procedure. As an alternative to this procedure, one may also use a laryngeal balloon catheter to dilate the web, wherein pressures of about 10 atmospheres are applied for two minutes.

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