A balloon catheter is re-introduced (in this case, a 6 mm balloon) and under direct bronchoscopic control, the posterior tracheal wall is carefully split in a gradual manner until the entire stricture is divided. The anterior esophageal wall serves to prevent air leak and pneumothorax.
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Endoscopic photograph of divided posterior trachea. An endotracheal tube is then passed through the area of narrowing and left for two to three weeks. Extubation is performed with bronchoscopy. This patient was re-bronchoscoped once, three weeks post-extubation, and granulation tissue excised. The child is well at 3 years of age, with noisy respiration only when excited.