Skip to main content
Log in

Spiral CT virtual bronchoscopy with multiplanar reformatting in the evaluation of post-intubation tracheal stenosis: comparison between endoscopic, radiological and surgical findings

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

An Erratum to this article was published on 27 January 2009

Abstract

We evaluated the usefulness and accuracy of spiral CT in detection and assessment of post-intubation tracheal stenosis. Fourteen patients with post intubation stenosis underwent evaluation of their airway by spiral CT scan with multiplanar reformatting (MPR) and virtual endoscopy (VE) and conventional rigid bronchoscopy, and telescopy (RB). The following parameters were assessed: involvement of the subglottic larynx, site, number, and degree of the stenosis. The results were compared with the intra-operative findings. The detection rate for tracheal stenotic lesions was 94% by CT and 88% by rigid bronchoscopy. The sensitivity and specificity of both CT scan and bronchoscopy in the detection of subglottic stenosis was 100%. The preoperative assessment of the length of stenosis was accurate in 14 (87%) of the 16 stenotic segments detected by CT and in 11 (73%) of the 15 segments detected by bronchoscopy. The length of stenosis as assessed intra-operatively significantly correlated with the data obtained with CT scan (r = 0.98, p < 0.001) and RB (r = 0.94, p < 0.001). The grade of stenosis was correctly assessed by bronchoscopy in 13/15 lesions (86%). CT measurements correctly estimated 15/16 (93.75%) lesions and allowed accurate measurements of the stenotic segment as well as the proximal and distal airway segments. Spiral CT scan with MPR and VE may be considered as a substitute to direct endoscopic examination and the additional information on laryngeal function can be easily obtained during flexible nasolaryngoscopic examination of the awake patient. This policy can minimize patient morbidity and spare them an extra anaesthetic for evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Braz JR, Navarro LH, Takata IH, Nascimento JP (1999) Endotracheal tube cuff pressure: need for precise measurement. Sao Paolo Med J 117:243–246

    CAS  Google Scholar 

  2. Wain JC (2003) Postintubation tracheal stenosis. Chest Surg Clin N Am 13(2):231–235

    Article  PubMed  Google Scholar 

  3. Kagadis GC, Patrinou V, Kalogeropoulou CP et al (2001) Virtual endoscopy in the diagnosis of an adult double tracheal bronchi case. Eur J Radiol 40(1):50–53

    Article  PubMed  CAS  Google Scholar 

  4. Amorico MG, Drago A, Vetruccio E et al (2006) Tracheobronchial stenosis: role of virtual endoscopy in diagnosis and follow-up after therapy. Radiol Med 111(8):1064–1077

    Article  PubMed  CAS  Google Scholar 

  5. Grenier PA, Beigelman-Aubry C, Fetita C et al (2002) New frontiers in CT imaging of airway disease. Eur Radiol 12(5):1022–1044

    Article  PubMed  Google Scholar 

  6. Finkelstein SE, Summers RM, Nguyen DM et al (2004) Virtual bronchoscopy for evaluation of airway disease. Thoracic Surg Clin 14(1):79–86

    Article  Google Scholar 

  7. Ferguson JS, McLennan G (2005) Virtual bronchoscopy. Proc Am Thorac Soc 2(6):488–491, 504–505

    Google Scholar 

  8. Koletsis EN, Kalogeropoulou C, Prodromaki E et al (2007) Tumoral and non-tumoral trachea stenosis: evaluation with three-dimensional CT and virtual bronchoscopy. J Cardiothoracic Surg 2(18):1–7

    Google Scholar 

  9. Naidich DP, Gruden JF, McGuinness G et al (1997) Volumetric (helical/spiral) CT (VCT) of the airways. J Thorac Imaging 12(1):11–28

    Article  PubMed  CAS  Google Scholar 

  10. Rubin GD (2000) Data explosion: the challenge of multidetector row CT. Eur J Radiol 36(2):74–80

    Article  PubMed  CAS  Google Scholar 

  11. Salvolini L, Bichi Secchi E, Costarelli L et al (2000) Clinical applications of 2D and 3D CT imaging of the airways: a review. Eur J Radiol 34(1):9–25

    Article  PubMed  CAS  Google Scholar 

  12. Carretta A, Melloni G, Ciriaco P et al (2006) Preoperative assessment in patients with postintubation tracheal stenosis. Surg Endosc 20:905–908

    Article  PubMed  CAS  Google Scholar 

  13. Bauer TL, Steiner KV (2007) Virtual bronchoscopy: clinical applications and limitations. Surg Oncol Clin N Am 16:323–328

    Article  PubMed  Google Scholar 

  14. McAdams HP, Palmer SM, Erasmus JJ et al (1998) Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment. Radiology 209:689–695

    PubMed  CAS  Google Scholar 

  15. Sun M, Armin E, Boiselle PM (2007) MDCT of the central airways: comparison with bronchoscopy in the evaluation of complications of endotracheal and tracheostomy tubes. J Thorac Imaging 22:136–142

    Article  PubMed  Google Scholar 

  16. Filkenstein SE, Schrump DS, Nguyen DM et al (2003) Comparative evaluation of super high-resolution CT scan and virtual bronchoscopy for the detection of trachobronchial malignancies. Chest 124:134–184

    Google Scholar 

  17. Jones CM, Athanasiou T, Nair S et al (2005) Do technical parameters affect the diagnostic accuracy of virtual bronchoscopy in patients with suspected airways stenosis? Eur J Radiol 55:445–451

    Article  PubMed  Google Scholar 

  18. Maniatis PN, Triantopoulou CC, Tsalafoutas IA (2006) Virtual bronchoscopy versus thin section computed tomography in evaluation of moderate and low grade stenoses: receiver operating characteristic curve analysis. Acta Radiol 47:48–57

    Article  PubMed  CAS  Google Scholar 

  19. Hoppe H, Walder B, Sonnenschein M et al (2002) Multidetector CT virtual bronchoscopy to grade tracheobronchial stenosis. Am J Roentgenol 178:1195–1200

    Google Scholar 

Download references

Conflict of interest statement

We hereby state that none of the authors has any conflict of interest or financial relationship to any commercial firm or organization.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Badr Eldin Mostafa.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00405-008-0884-5

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taha, M.S., Mostafa, B.E., Fahmy, M. et al. Spiral CT virtual bronchoscopy with multiplanar reformatting in the evaluation of post-intubation tracheal stenosis: comparison between endoscopic, radiological and surgical findings. Eur Arch Otorhinolaryngol 266, 863–866 (2009). https://doi.org/10.1007/s00405-008-0854-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-008-0854-y

Keywords

Navigation