PURPOSE: Our literature search indicates that although tracheal stenosis has been documented as a complication of tracheostomy, data is lacking as to its location, severity, age difference and sex difference. We conducted this study to answer the above questions.
METHODS: Retrospective review of bronchoscopic database of patients with at least 6 months duration of tracheostomy over a period of 2005 to 2009. Tracheal stenosis was defined as at least 10% narrowing of the lumen. It was categorized into anterior superior suprastomal (AL), anterior lateral suprastomal and posterior lateral suprastomal. Also, it was classified as mild (< 25%), moderate (25-50%), severe (50-75%) and very severe (> 75%) stenosis.
RESULTS: Of 101 patients included in the study, 65 (64.9%) patients had tracheal stenosis according to our criteria. Anterior superior suprastomal (AS) was the most common location 59 patients (90.1%) followed by anterior lateral suprastomal (AL) 5 patients (0.07%) and posterior lateral suprastomal (PL)one patient (0.01%). In the AS category 27 patients (46%) had mild stenosis, 15 patients (25%) had moderate stenosis, 5 patients (8.4%) had severe stenosis and 12 patients (20%) had very severe stenosis. Using Fisher’s exact test for age and sex as independent variables and location as dependent variable, we found that AS location was more common in males and females > 60 years of age ( p value 0.013). The mean age of patients was 61.58, median 63.2 and standard deviation 13.84. Comparison of means for age using Independent sample t test showed mean age for males 57.68 was lower than females 64.94 (p value 0.031).
CONCLUSION: Anterior superior suprastomal (AS) location is the most common location of tracheal stenosis in patients > 60 years of age. Tracheal stenosis tends to occur earlier in males than females.
CLINICAL IMPLICATIONS: Tracheal stenosis is a known complication in patients with > 6 months of tracheostomy. It is an important but avoidable cause of upper airway obstruction in this patient population.
DISCLOSURE: Sandeep Riar, No Financial Disclosure Information; No Product/Research Disclosure Information