Tracheal resection and reconstruction is the treatment of choice for benign tracheal stenosis. The success rate is more than 90%, but restenosis may occur in 4-16% of cases as reported in the major series, and the treatment remains a challenge. Patients unfit for redo-TRR, with insufficient subglottic space for stenting had no other alternative treatment options than definitive tracheostomy.
We reported the use of modified Dumon stent as temporary bridge to industry ,a custom new laryngo-tracheal stent for treatment of a life-threatening subglottic stenosis after TRR in definitive way. We created a new type of stent that has proximal end presents V-shaped cuts that created a duck bill shape that conformed to the inner laryngeal contours and restored the complex triangular shape of the glottis.
The use of this prosthesis needs the integrity of hypo pharyngeal peristalsis, and a normal function of tongue to prevent aspiration, and preserve stent patency. Thus, it is not indicated in patients with neurological or surgical disorders that impair swallowing.
Finally, our new prosthesis may be a useful adjunct to the current stents for the treatment of difficult subglottic stenosis. In the future, the 3D-printed customized stents certainly facilitate the management of laryngo-tracheal region.