Tracheal Stenosis and its Management - A Single Institution 10 Years Experience.

Abstract

To analyze patient characteristics, diagnostic methods, management strategies and outcomes in tracheal stenosis following intubation or tracheostomy over a 10-year period at a tertiary care center. Retrospective observational study. Tertiary care hospital. Eighteen patients diagnosed with tracheal stenosis from 2015 to 2024 following extubation or decannulation. Data collection included patient demographics, stenosis characteristics (type and site), diagnostic approaches, treatment modalities and outcomes. Patients were evaluated through history, physical examination, and endoscopic/imaging assessments. Management included endoscopic and open surgical interventions. Treatment success was defined as decannulation with satisfactory voice quality. Among 18 patients, middle-aged males were the predominant demographic and typically presented within 20 days post-extubation or decannulation. Of the 9 post intubation tracheal stenosis cases, 6 had web-like stenosis at the cuff site and 3 developed granulation tissue. The remaining 9 cases were post tracheostomy-related, with 4 showing granulation at the stoma, 3 involving cartilage fractures and 2 developing web-like stenosis. Endoscopic management (44.4%) involved bronchoscopic or bougie dilatation with mitomycin C application. Surgical interventions (55.5%) used composite hyoid-sternohyoid grafts (50%), costal cartilage (30%), and tracheoplasty with T-tube placement (20%). Decannulation was successful in 71.4% of endoscopic and 66.6% of surgical cases. Comprehensive evaluation and individualized management based on stenosis characteristics are essential for optimal outcomes in tracheal stenosis.