• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.512-517
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• 2005

Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

• Tuberculosis and Respiratory Diseases
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• v.74 no.2
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• pp.82-85
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• 2013

A 62-year-old man with a chronic cough presented with atelectasis of the left upper lobe on chest X-ray. Chest computed tomography showed an atelectasis in the left upper lobe with bronchial wall thickening, stenosis, dilatation, and mucoid impaction. We performed bronchoscopy and found a well-circumscribed mass on the left upper lobe bronchus. The mass was removed by flexible bronchoscopy using an electrosurgical snare and diagnosed with lipoma. An endobronchial lipoma is a rare benign tumor that can be treated by a surgical or endoscopic approach. We report the successful removal of endobronchial lipoma via flexible bronchoscopic electrosurgical snare.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.238-243
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• 1996

Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.38-43
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• 1977

With the adevance of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. We have experienced these diseased of the 3 cases in our department. The first case was a 25 year old male who was severe dyspneic and subcutaneous emphysema, hemoptysis, and hemopneumothorax of both side were noted. During tracheostomy, it was found that the 2net ring of the trachea was ruptured. No definitive procedure was made on admission. Corrective surgery was performed with end-to-end anastomosis on 31 post-traumatic day. The second case was a 43 year old female who received multiple stab wounds on the anterior neck and it was found that the cricoid cartilage was transected partially. The injured cartilage was approximated with interrupted suture of No. 600 wire. The third case was a 19 year old male who had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he had suffered from dyspnea, and obstruction of the left main bronchus due to traumatic bronchial rupture was confirmed by means of bronchoscopy and bronchography at two weeks after the trauma. End-to-end anastomosis of the bronchus was performed and the left lung was aerated well. Mild postoperative stenosis of trachea was remained in the first case. Others were uneventful.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.177-180
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• 2000

Backgrounds： Patients with respiratory failure may require prolonged mechanical ventilation. The purpose of this study was to determine the optimal time for tracheostomy and complications of tracheostomy. Methods : All medical records of 27 patients who underwent tracheostomy in department of thoracic & cardiovascular surgery at Yondong Severance hospital between January 1, 1990 and December 31, 1998, were reviewed. Variables analyzed include underlying disease, primary indication of tracheostomy, interval from 1st intubation to tracheostomy, duration from tracheostomy to weaning ventilator, duration of decannulation, and complication. There were 18 men and 9 women. Mean age at the time of the tracheostomy was 54 years (rage, 11 to 64 yeras). Results : Underlying diseases included lung cancer in 14 patients (51.9%), trauma in 8 patients (29.6%), and TE fistula in 2 patients. The indication for tracheostomy were as follows: prolonged mechanical ventilation in 13 patients, purpose of bronchial toilet in 9 patients, and tracheal stenosis in 5 patients. The mean interval between the first intubation and tracheostomy was 8.1 days. The mean duration from tracheostomy to weaning ventilator was 10.1 days. Conclusions : Timing of tracheostomy Is very important. Tracheostomy may benefit patients because it can accelerate the process of weaning and thus lead to a reduction in the duration of ventilation, length of hospitalization, and cost.

• Korean Journal of Bronchoesophagology
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• v.18 no.1
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• pp.5-8
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• 2012

Cryosurgery is a safe method for palliation of endobronchial malignancies causing airway obstruction. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryosurgery is considered to be a good method that is clinically applicable to a malignant endobronchial tumor. In cases with stenosis caused by an endoluminal tumor, cryo-recanalization with a cryoprobe was immediately effective in most of the patients. A novel technique described by Hetzel in 2004 to achieve rapid recanalization of central airway obstruction with endobronchial cryoprobe. Cryorecanalization technique is feasible and offers many advantages in the interventional therapy of malignant intraluminal tumors of the respiratory tract.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1441-1476
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• 2021

The tracheobronchial tree is a system of airways that allows the passage of air to aerate the lungs and entire body. Several pathological conditions can affect this anatomical region. Multidetector CT (MDCT) helps identify and characterize various large airway diseases. Post-processing tools, such as virtual bronchoscopy and automatic lung analysis, can help enhance the performance of imaging studies. In this pictorial essay review, we provide imaging findings of various bronchial lesions manifested as wall thickening and endoluminal nodules on conventional MDCT and advanced image visualization and analysis.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.671-682
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• 1996

Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.347-359
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• 1996

Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usually arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential for extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolonged course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She has been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed as bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenoid cystic carcinoma by bronchoscopic biopsy. The patient underwent radiation to relieve a bronchial stenosis caused by her tumor. The patient has remained well and is asymptomatic without evidence of clinical recurrence. The other case was 25 year old female. She complained shortness of breath and inspiratory difficulty during sleep. The tumor was located in upper trachea, which protruded from the posterior wall of the trachea and obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenocystic carcinoma by rigid bronchoscopic biopsy. The patient was underwent operation for removal of the mass and received radiotherapy. The patient has remained well are following up now.

• Tuberculosis and Respiratory Diseases
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• v.53 no.3
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• pp.337-343
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• 2002

A tracheal bronchus, an aberrant bronchus arising directly from the trachea, is an infrequent congenital anomaly. The incidence of this anomaly ranges from 0.5 to 5%. It usually originates from the right lateral wall of the trachea at the level <2 cm above the tracheal bifurcation. These patients usually are asymptomatic, but some patients may experience recurrent pneumonia, chronic bronchitis, bronchiectasis, or asthmatic episodes. A tracheal bronchus may be associated with other anomalies such as a tracheal stenosis, pulmonary agenesis, pulmonary sequestration, congenital heart disease, a pulmonary venous anomaly and Down's syndrome. This anomaly is usually diagnosed incidentally during bronchoscopy in patients with respiratory problems. Here we report a case of a 20-year-old man with a past history of bronchial asthma, which was incidentally diagnosed as a tracheal bronchus during a medical examination prior to military service, and was associated with a bilateral superior vena cava anomaly.