DEMOGRAPHIC EVALUATION OF LARYNGO-TRACHEAL STENOSIS FOLLOWING PROLONGED ENDOTRACHEAL INTUBATION

Prolonged trans-laryngeal intubation is associated with increased laryngeal injury, glottic and sub-glottic stenosis, infectious complications, and tracheal injury such as tracheomalacia, and tracheal stenosis. Several studies assessing the laryngeal complications are available in Caucasoid populations. Minimal data are available in the literature related to Iran. In this study we have evaluated the etiological factors of laryngo-tracheal stenosis following intubation. It was a prospective analytical study in Otolaryngology-Head and Neck Surgery Department, Ahwaz Jondishapour University of Medical Sciences, from 2004 until 2006 (19 months) in Ahwaz, Iran. Ninety eight patients (61 patients were male) who were intubated for more than 48 hours in Imam Khomeini, Golestan and Razi University Hospitals critical care unit with different causes and were referred to otolaryngology emergency ward with respiratory distress (The prevalent cause was head trauma) were enrolled in the study. All patients underwent laryngeal video endoscopy and laryngeal computed tomography scan at by an otolaryngologist surgeon who was blinded to the intubation variables. Twenty five patients had been presented by laryngo-tracheal stenosis and the most common site of that was sub-glottic area (sixteen patients). Statistical analytic findings showed that from several factors such as tube size (P=0.088), skill of intubating doctor (consultant or registrar; P =0.146), duration of intubation (P =0.002) and emergency intubation (P = 0.240) only prolonged intubation (P=0.002) was associated with higher incidence of laryngo-tracheal stenosis. In conclusion, laryngo-tracheal stenosis after prolonged endotracheal intubation was directly associated with duration of intubation. The most common site of laryngeal stenosis was sub-glottic area.