Tracheal stenosis aftertracheostomy or intubation: review with special regard to cause and management

Tex Heart Inst J. 2005;32(2):154-8.

Abstract

To investigate the management outcomes of patients who developed tracheal stenosis after tracheostomy or intubation, we reviewed the courses of 45 patients who had experienced tracheal stenosis at a single institution, over 19 years from February 1985 through January 2004. There were 38 tracheal and 7 infraglottic stenoses. Twenty-nine stenoses were associated with the stoma, 12 with the cuff, and 2 with the endotracheal tube resulting in infraglottic lesions; the remaining 2 were double stenoses. Eleven patients were treated by bronchoscopic surgery, and 34 patients were treated by tracheal or laryngotracheal resection. The overall success rate was 93%. The complication rate was 18%. A 2nd operation was required in 3 patients, and 1 of the 3 died of sepsis. Our management strategy of treating tracheal stenosis with resection and end-to-end anastomosis has been associated with good outcomes. Management of infraglottic stenosis is difficult, particularly when there is a large laryngeal defect or when there have been previous surgical attempts at the same site.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthesia, General
  • Bronchoscopy
  • Female
  • Humans
  • Intubation, Intratracheal / adverse effects*
  • Larynx / surgery
  • Male
  • Trachea / surgery
  • Tracheal Stenosis / epidemiology
  • Tracheal Stenosis / etiology*
  • Tracheal Stenosis / surgery*
  • Tracheostomy / adverse effects*