The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial
tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually
leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is
often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway,
its treatment needs such special measures as steroid therapy, surgical intervention
and/or laser therapy, but the therapeutic result is often disappointing.
To exploit a new treatment modality for bronchial stenosis, balloon dilatation was
carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia,
4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzing
balloon was introduced under fluoroscopic guide in two others.
Endobronchial tuberculoses were subdivided into two(16.7%) with actively castrating
type, seven(58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without
fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all
stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four
(57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with
actively-caseating type and three with stenotic type without fibrosis) were improved
with this method. FEV1.0or FVC increased 10% or more after procedure
in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of
twelve, in whom follow-up examination was done after the procedure.
Balloon dilatation of bronchial stenosis is more effective, when endobronchial
tuberculosis is in active stage than in healed fibrotic stage. It is suggested that
bronchial stenosis can be minimized by early diagnosis and early application of balloon
dilatation in the course of disease.
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