To the Editor: Tracheoesophageal fistulas (TEFs) are either congenital (seen in roughly 0.04% of newborn infants) or acquired. Acquired TEFs in adults can either be "benign" TEFs resulting from iatrogenic insult such as airway procedures or endotracheal cuff injury in prolonged intubation, or due to malignancy, primarily eso-phageal cancer. Although uncommon, TEFs carry significant morbidity from recurrent aspiration pneumonia and malnutrition which can decrease patient quality of life. Surgical correction is deemed definitive, however, this carries significant morbidity and is often limited by underlying cancer and concomitant malnutrition. As such minimally invasive endoscopic management, such as esophageal and or tracheal stenting, has become appealing. In this case report we describe the use of a silicone septal nasal occluding device to treat a symptomatic TEF using a rigid stent deployer through an existing tracheal stoma.
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