Abstract
Before the use of tantalum powder, positive contrast studies of the trachea were performed with a viscous oily iodine suspension. Iodine in suspension is not very radiopaque, and is moderately toxic. The oily portion of the contrast media is viscous and tends to obstruct the airways. In patients with compromised airway diameters such as those with tracheal stenosis, a positive contrast study was often considered too dangerous to perform. At this time, operability and the type of surgery anticipated was based on radiologic studies with poor anatomical detail. Tantalum is a safe contrast agent which is exceptionally radiodense and nontoxic. A small amount of tantalum dust coats the airway, giving excellent detail without compromising the airway diameter. Radiographic studies demonstrate excellent anatomical detail and are obtained with little patient discomfort. There have been no complicaions. Thirty-two patients with suspected tracheal stenosis have been studied by a protocol utilizing powdered tantalum as the contrast agent. Seven were normal. Varying degrees of tracheal stenosis were found in 18 patients. Five had only tracheomalacia, eight patients had a combination of both stenosis and malaria. Tracheomalacia was discovered in three patients in whom it was not suspected clinically. Consequently we are performing cine examinations on all patients with suspected high airway obstruction. Certain technical details are crucial to the proper performance of this procedure. These, as well as the characteristic findings in each disease category, are presented.
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