Simple fixation methods for proximal tracheal silicone stents: experience from two cases

Migration is a frequent and clinically significant complication of silicone stents used in the management of benign proximal tracheal stenosis. Commercial fixation systems are available, yet they may be costly, technically demanding, or not readily accessible in many institutions. This report presents two simple, low-cost fixation techniques that were applied to stabilize proximal tracheal silicone stents, aiming to prevent migration without the need for dedicated devices. Two patients with high-grade benign proximal tracheal stenosis underwent silicone stent placement. In the first patient, external stabilization was achieved using a transcutaneous fixation technique: a 16G intravenous catheter was inserted through the anterior cervical skin into the tracheal lumen, allowing passage of a Prolene® suture that was retrieved bronchoscopically and secured externally. In the second patient, the stent was stabilized using a nasal fixation technique in which a suture placed at the proximal end of the stent was exteriorized through the nasal passage with flexible bronchoscopy and anchored externally. Both procedures were completed safely, without bleeding, infection, or migration during follow-up. These two cases demonstrate practical, inexpensive, and reproducible alternatives for stabilizing proximal tracheal silicone stents using basic surgical materials. Such techniques may be valuable in centers where commercial fixation systems are unavailable or impractical, offering reliable solutions to prevent stent migration in benign airway stenosis.