Transbronchoscopic Local Injection of Triamcinolone Acetonide for Subglottic Granulation Tissue: A Case Report.

Subglottic granulation tissue is a rare but recurrent cause of airway stenosis that develops after epithelial injury from endotracheal intubation or other insults. We herein report a 19-year-old woman who developed progressive dyspnoea 2 months after intubation for autoimmune encephalitis. Bronchoscopy revealed a pedunculated subglottic mass, which was resected with an electrocautery snare. Histology confirmed granulation tissue. Despite initial therapy, recurrence occurred within 2 weeks. A second bronchoscopic resection was performed, followed by the local injection of 8 mg of triamcinolone acetonide (TA) into the base of the lesion. Subsequent bronchoscopic surveillance over 4 months demonstrated no recurrence. TA exerts anti-inflammatory and antifibrotic effects and, when administered locally, it provides a high drug concentration with minimal systemic toxicity. Only a few cases of airway stenosis due to granulation tissue treated transbronchoscopic TA injection have been reported. This minimally invasive approach is a safe and effective treatment option for recurrent airway granulation lesions.