Tracheal Stenosis after Tracheostomy |
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| Authors: | Potter James Sat Parmar Khalid Hussain Prav Praveen |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;2. Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait;3. Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany;4. Carinthia University of Applied Sciences, Europastrasse 4, 9524 Villach, Austria;1. Department of Oral and Maxillofacial Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom;2. Department of Cellular Pathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom;1. University of Glasgow Medical School University Avenue, Glasgow G12 8QQ;2. Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF;3. Oral and Maxillofacial Surgery Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF;4. Scottish Human Papilloma Virus Reference Laboratory Specialist Virology Centre, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh EH16 4SA;5. Aberdeen Royal Infirmary, Aberdeen AB25 2ZN;6. Institute of Cancer Sciences and Clinical Oncologist Beatson West of Scotland Cancer Centre 1053 Great Western Road, Glasgow G12 0YN;7. Head & Neck/Maxillofacial Surgeon Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF;1. Regional Maxillofacial Unit, Aintree University Hospital, Liverpool L9 7AL, UK;2. Astraglobe Ltd., Congleton, Cheshire |
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| Abstract: | INTRODUCTIONTracheal stenosis is a late and usually non-life threatening complication of surgical and percutaneous tracheostomies (PDT) as well as delayed endotracheal extubation.METHODSWe undertook a retrospective review of all patients who underwent a surgical tracheostomy over a 10 year period. Patients were included in the study if they had CT or MRI imaging of the tracheostomy site both pre-operatively and six or more weeks post operatively. Patients whose imaging was not available were excluded (n = 3) as were those patients who still had a tracheostomy in situ (n = 8). In total 91 patients were included in the study. In the same period 1170 surgical tracheostomies were performed by the maxillofacial surgeons. The images were analysed by a radiologist and the degree of stenosis reported.RESULTSAll 91 patients underwent a tracheostomy with a window. 83 patients did not demonstrate any stenosis. Looking at the remaining 8 patients with stenosis: 6 patients had stenosis of less than 25%, 1 patient had stenosis between 25-50% and 1 patient had stenosis greater than 50%. Both patients with stenosis greater than 25% had more than one surgical tracheostomy.CONCULSIONWe have shown that the risk of stenosis is 8.8%, lower than often quoted in literature, and when it occurs it is likely to be symptomatic only in severe stenosis. Our main risk of stenosis was repeat surgical tracheostomies which also seems to be linked to a greater degree of stenosis. |
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| Keywords: | Tracheal Stenosis Surgical Tracheostomy Retrospective Review Percutaneous Tracheostomy Maxillofacial Surgery Queen Elizabeth Hospital Birmingham |
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