Laryngo-tracheal stenosis following endotracheal intubation
Abstract
Background: Despite significant improvements in the biocompatibility of materials used for tracheal tubes, laryngeal and tracheal lesions as long-term complications of artificial airways continue to be problematic in patients requiring prolonged airway support.
Methods: We present a case of postintubation tracheal stenosis in a 63-year-old woman with a history of dyspnoea on exertion after a relatively short period of intubation. Endoscopic examination performed a few weeks later revealed a tracheal stenosis. Consequently, she underwent a tracheal resection and reconstruction with good overall result.
Conclusions: We highlight the fact that some patients with airway narrowing could be misdiagnosed as having bronchial asthma. The incidence of airway stenosis is relatively low, but a history of artificial airway should always be obtained. Endotracheal tube size and cuff pressure vare considered as two major risk factors for laryngo-tracheal stenosis.
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References
Richard DS, Irawan S. Long-term complications of artificial airways. Clin Chest Med 2003; 24: 457–71.
Noppen M, Schlesser M, Meysman M, D’Haese J, Peche R, Vincken W. Bronchoscopic balloon dilatation in the combined management
of postintubation stenosis of the trachea in adults. Chest 1997; 112: 1136–40.
Loh KS, Irish JC. Traumatic complications of intubation and other airway management procedures. Anesthesiol Clin North
America 2002; 20: 953–69.
Aguilera IM, Walker RWM, Dearlove OR. Postintubation tracheal stenosis in an 11-year-old boy: a surgical and anaesthetic challenge. Paediatr Anaesth 2002; 12: 733–7.
Santos PM, Afrassiabi A, Weymuller EA. Risk factors associated with prolonged intubation and laryngeal injury. Otolaryng Head Neck Surg 1994; 111: 453–9.
Koledin M, Jović R, Milošević M, Macedonić B, Milivojević S, Đurić D, et al. Postintubaciona stenoza traheje. Pneumonia 2004; 41: 1.
Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB, et al. A prospective, randomized, study comparing early percutaneous dilatational traheotomy to prolonged translaryngeal intubation (delayed traheotomy) in critically ill medical patients. Crit Care Med 2004; 32: 1689–93.
Feller-Kompan D. Acute complications of artificial airways. Clin Chest Med 2003; 24: 445–55.
Raghuraman G, Rajan S, Marzouk JK, Mullhi D, Smith FG. Is tracheal stenosis caused by percutaneous tracheostomy different from that by surgical tracheostomy? Chest 2005; 3: 879–84.
Wynn R, Har-El G, Lim WJ. Tracheal resection with end-to-end anastomosis for benign tracheal stenosis. Ann Otol Rhinol Laryngol 2004; 113: 613–7.
Nagappan R, Parkin G, Wright CA, Walker CS, Vallance N, Buchanan D, et al. Adult long-segment tracheal stenosis attributable to complete tracheal rings masquerading as asthma. Crit Care Med 2002; 30: 238–40.
Brichet A, Verkindre C, Dupont J, Carlier ML, Darras J, Wurtz A, et al. Multidisciplinary approach to management of postintubation tracheal stenosis. Eur Respir J 1999; 13: 888–93.
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