Nd-YAG laser surgery for severe tracheal stenosis physiologically and clinically masked by severe diffuse obstructive pulmonary disease.

Nd-YAG laser surgery was performed on six patients with tracheal stenosis complicating severe diffuse intrathoracic airways obstruction due to emphysema, chronic obstructive bronchitis and/or asthma. Tracheal stenosis was extrathoracic in four patients and both extrathoracic and intrathoracic in two patients. Results suggest that patients with severe chronic obstructive pulmonary disease and asthma have maximal expiratory and inspiratory flow volume patterns that may completely mask extrathoracic and intrathoracic tracheal stenosis. Following relief of tracheal obstruction with laser therapy, substantial improvement can occur both clinically and physiologically, as reflected by symptomatic relief and large increases in Vmax 50I and FVC.