Clinical profile of patients with laryngotracheal stenosis in a tertiary government hospital

ABSTRACT

@#<p style="text-align justify;"><strong>OBJECTIVE:</strong> To describe the clinical profile of patients with laryngotracheal stenosis over a 7-year period and discuss strategies for its prevention.<br /><strong>METHODS:</strong><br /><strong>    Design:</strong> Retrospective Case Series<br /><strong>    Setting:</strong> Tertiary Government Hospital<br /><strong>  Participants:</strong> Thirteen (13) patients with laryngotracheal stenosis confirmed by laryngoscopy and/or bronchoscopy.<br /><strong>RESULTS:</strong> Twenty-one patients were evaluated for laryngotracheal stenosis from January 2008 to June  2015, but only 13 with complete data were included in this study. Of the 13 patients, nine (69.2%) belonged to the pediatric age group. Ten (77%) were males and three (23%) were females. Laryngotracheal  stenosis  following endotracheal  tube  (ET)  intubation  was  seen in 11 (84.6%) while 2 had thyroid masses and no  history  of  prior  ET  intubation.  Presenting symptoms or reasons for referral were wheezing (n=4), stridor (n=4), failure to decannulate the tracheostomy tube (n=3), and dyspnea (n=2). Duration of ET intubation was four to 60 days. The highest frequency of ET re-intubation was 5 times. Among those intubated, stenosis was glottic in one, subglottic in five and tracheal in five patients. Three had Cotton-Myer grade I stenosis, two had grade II, three had grade III and three had grade IV stenosis. Those with thyroid masses had tracheal stenosis.<br /><strong>CONCLUSION:</strong> Strategies  for  prevention  of  laryngotracheal  stenosis  should include  routine airway  endoscopy  for  patients  with  longstanding  neck  masses  and  for  those  with  prolonged ET  intubation,  for  whom  the  option  of  early  prophylactic  tracheostomy  is  worth  considering. Otherwise, immediate post-extubation endoscopy may facilitate documentation and appropriate<br />intervention.</p>