ABSTRACT
To determine the causes of upper airway obstruction leading to tracheostomy; endoscopic evaluation was done in Khalili Hospital, Iran. During a 2 year period, 47 patients who underwent tracheostomy, were evaluated endoscopically to determine the causes of airway obstruction leading to tracheostomy. Forty-seven cases were included in the study including 40 males and 7 females with mean age of 31.9 years. The most common cause of obstruction was subglottic stenosis [40.%] and laryngeal carcinoma [38.3%]. The cause of subglottic stenosis in the majority of the patients was prolonged endotracheal intubations [95%]. Other less common causes were direct laryngeal trauma [4.5%], vocal cord paralysis [2.1%], supraglottitis [2.1%], tracheal foreign bodies [2.1%], severe trismus [2.1%], and status asthmaticus [2.1%]. Subglottic stenosis secondary to prolonged intubations is the major cause of upper airway obstruction leading to tracheostomy. Converting endotracheal intubations to tracheostomy in patients who need prolonged ventilator support may prevent subglottic stenosis and decrease the rate of serious complications following prolonged endotracheal intubations