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Tracheal stenosis after percutaneous dilational tracheotomy
Sande Bartels1, John C Mayberry, Robert K Goldman
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland 97201-3098, USA.
Summary
Percutaneous dilational tracheotomy (PDT) can lead to tracheal stenosis, but this study found only one of ten patients developed asymptomatic stenosis. The risk appears similar to open tracheotomy.
Area of Science:
- Critical care medicine
- Otolaryngology
- Pulmonology
Background:
- Percutaneous dilational tracheotomy (PDT) is a common alternative to open tracheotomy in critical care.
- While tracheal stenosis post-PDT is known, its precise incidence remains unclear.
- This study investigates the long-term incidence of tracheal stenosis after PDT.
Purpose of the Study:
- To determine the incidence of tracheal stenosis following percutaneous dilational tracheotomy (PDT).
- To assess the clinical significance and patient-reported outcomes of airway and voice quality after PDT.
Main Methods:
- Retrospective review of 108 trauma patients who underwent PDT >6 months prior.
- Flexible laryngotracheoscopy was performed on 10 eligible and consenting patients.
- Tracheal stenosis was categorized based on cross-sectional area reduction.
Main Results:
- One out of 10 patients (10%) exhibited asymptomatic tracheal stenosis (25%-50% reduction).
- Five patients had no visible tracheotomy site changes.
- Four patients had visible scars but no significant airway compromise.
Conclusions:
- Significant tracheal stenosis after PDT is uncommon, occurring in 10% of this cohort.
- The observed stenosis was asymptomatic, with no impact on voice or airway.
- The risk of tracheal stenosis from PDT appears comparable to open tracheotomy.