Tehran University Medical Journal

Background: Prolonged endotracheal intubation is a growing method for supporting ventilation in patients who require intensive care. Despite considerable advancement in endotracheal intubation, this method still has some complications the most important is laryngo-tracheal injuries.                   

Methods: Over a 2-year period, this retrospective study was conducted on 57 patients with history of prolonged intubation who were referred to the ENT Department of Amir Alam Hospital. For each patient, a complete evaluation including history, physical examination, and direct laryngoscopy and bronchoscopy was done under general anesthesia.

Results: Fifty-seven patients (44 male mean age, 23.014.7 years) were studied. Mean intubation period was 15.88 days. The most common presenting symptom was dyspnea (62%). Head trauma was responsible for most cases of intubation (72.4%). The most common types of tracheal and laryngeal lesions were tracheal (56.9%) and subglottic (55.2%) stenosis, respectively. Mean length of tracheal stenosis was 0.810.83 cm. There was a statistically significant relationship between length of tracheal stenosis and intubation period (P=0.0001) but no relation was observed between tracheal stenosis and age, sex, and etiology of intubation (All P=NS). Among the glottic lesions, inter- arytenoids adhesion was the most common lesion (25.9%). No statistically significant relation was found between glottic and subglottic lesions and age, sex and intubation period (all P=NS). Length of stenosis and intubation period was significantly greater in tracheal/ subglottic lesions than those in glottic/ supraglottic lesions (all P=NS).

Conclusion: After prolonged endotracheal intubation, laryngo-tracheal lesions had no relation with patient’s age, sex, and cause of intubation.There was direct relation between length of tracheal stenosis and intubation period. Glottic lesions were more commonly observed in head trauma patients. Lesion length and intubation period were greater in tracheal and subglottic lesions.