Hashimoto Ryo, Mitsutomo Kohno, Hiroto Onozawa, Naohiro Aruga, Kana Ohiwa, Tomoki Nakagawa, Masuda Ryota, Iwazaki Masayuki
Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Department of General Thoracic Surgery, Saitama Medical Centre, Saitama Medical University, Saitama, Japan.
Respir Med Case Rep. 2025 Jul 1;57:102252. doi: 10.1016/j.rmcr.2025.102252. eCollection 2025.
Granulations may form in the trachea during tracheostomy cannula placement, resulting in airway narrowing. Managing stenosis is difficult when the cannula cannot be removed. Herein, we report a case of long-term regression and maintenance of intratracheal granulation following local injection of triamcinolone acetonide (TA).
A 14-year-old boy presented to our pediatric department with epilepsy and psychomotor retardation. He was born at 24 weeks and 4 days of gestation and weighed 705 g at birth. He underwent a tracheostomy for tracheomalacia at 1 year of age. At the age of 12 years, granulation formed at the tip of the tracheostomy cannula, resulting in severe tracheal stenosis, which was repeatedly managed using ventilator management and replacement cannulas. As bronchoscopic cauterization and removal of the granulation tissue did not improve the condition, triamcinolone acetonide solution was injected into the granulation tissue three times, which resulted in regression of the granulation. Thereafter, no restenosis has been observed for more than 8 years.
We encountered a case in which the local injection of triamcinolone acetonide into the intratracheal granulation caused by a tracheostomy cannula was very effective, and no regrowth of the granulation was observed for a long period of time, even though the cannula remained in place.
气管切开插管置入过程中气管内可能形成肉芽组织，导致气道狭窄。当插管无法拔除时，处理狭窄较为困难。在此，我们报告一例在局部注射曲安奈德（TA）后气管内肉芽组织长期消退并维持的病例。
一名14岁男孩因癫痫和精神运动发育迟缓就诊于我院儿科。他出生时孕周为24周4天，出生体重705克。1岁时因气管软化接受气管切开术。12岁时气管切开插管尖端形成肉芽组织，导致严重气管狭窄，多次采用呼吸机管理和更换插管进行处理。由于支气管镜烧灼和切除肉芽组织未能改善病情，遂向肉芽组织内注射曲安奈德溶液3次，肉芽组织消退。此后，8年多未观察到再狭窄。
我们遇到一例气管切开插管所致气管内肉芽组织局部注射曲安奈德非常有效的病例，即使插管仍留在原位，长时间也未观察到肉芽组织再生长。
