Clinical implications of differentiating between types of post-tracheostomy tracheal stenosis.

Abstract:

Background:Post-tracheostomy tracheal stenosis (PTTS) can be divided into four types according to stenosis mechanism and site: subglottic, stoma, cuff, and tip granuloma. However, there is little information available regarding clinical differences among types of PTTS; therefore, we evaluated the clinical differences between these types. Methods:We retrospectively evaluated 99 PTTS patients who underwent interventional bronchoscopy between 2004 and 2014. Patients were divided into two groups according to pathophysiological similarities as follows: subglottic or stoma type (n=59) and cuff or tip type (n=40). Results:There were no differences in baseline characteristics between groups. However, silicone stents were more frequently needed in patients with subglottic or stoma type stenosis (76%) than those with cuff or tip type stenosis (55%, P=0.031) to maintain airway patency. On the contrary, permanent tracheostomy was more frequently performed in patients with cuff or tip type stenosis (50%) than those with subglottic or stoma type stenosis (19%, P=0.002). Finally, successful removal of the tracheostomy tube without surgery and procedure- or disease-related mortality were more frequently achieved in patients with subglottic or stoma type stenosis (71%) than those with cuff or tip type stenosis (45%, P=0.012). Conclusions:Although there were no significant differences in baseline characteristics between PTTS types, patients with subglottic or stoma type stenosis had more favorable outcomes than those with cuff or tip type stenosis. Therefore, it could be important to distinguish between types of PTTS when assessing prognosis.

journal_name

J Thorac Dis

authors

Shin B,Kim K,Jeong BH,Eom JS,Song WJ,Kim H

doi

10.21037/jtd.2017.10.99

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

4413-4423

issue

11

eissn

2072-1439

issn

2077-6624

pii

jtd-09-11-4413

journal_volume

9

pub_type

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