Tracheal stenosis complicating tracheostomy with cuffed tubes. Clinical experience and observations from a prospective study.

Abstract

UNTIL recently, the complication of tracheal stenosis following tracheostomy has been infrequently reported. In 1886, Colles described four patients developing tracheal strictures from among 57 survivors who required tracheostomy for the management of diphtheria. 1 The incidence of tracheal stenosis complicating the use of an uncuffed tracheostomy tube is reported to be less than 2% in several comprehensive reviews. 2,3 During the past ten years many forms of respiratory insufficiency have been managed by tracheostomy with a cuffed tube and intermittent, positive-pressure ventilation. An increasing number of reports 4-9 document tracheal stenosis as a significant complication of this type of tracheostomy. The reported incidence of stenosis ranges between 1% and 10% of those patients surviving treatment by tracheostomy with a cuffed tube. Strictures are described both in the region of the stoma and at the level of the inflatable cuff. The relative incidence of stenosis at the two levels varies