Subglottic and tracheal stenosis associated with coronavirus disease 2019

DW Scholfield, E Warner, J Ahmed… - The Journal of …, 2021 - cambridge.org
DW Scholfield, E Warner, J Ahmed, K Ghufoor
The Journal of Laryngology & Otology, 2021cambridge.org
BackgroundCoronavirus disease 2019 critical care patients endure prolonged periods of
intubation. Late tracheostomy insertion, large endotracheal tubes and high cuff pressures
increase their risk of subglottic and tracheal stenosis. This patient cohort also often appears
to have co-morbidities associated with laryngotracheal stenosis, including high body mass
index and laryngopharyngeal reflux. MethodsThis paper presents three coronavirus disease
2019 patients who were intubated for a mean of 28 days before tracheostomy, leading to …
BackgroundCoronavirus disease 2019 critical care patients endure prolonged periods of intubation. Late tracheostomy insertion, large endotracheal tubes and high cuff pressures increase their risk of subglottic and tracheal stenosis. This patient cohort also often appears to have co-morbidities associated with laryngotracheal stenosis, including high body mass index and laryngopharyngeal reflux.MethodsThis paper presents three coronavirus disease 2019 patients who were intubated for a mean of 28 days before tracheostomy, leading to complex multi-level stenoses.ResultsAll patients underwent multiple endoscopic tracheoplasty procedures and two required tracheal resections. There was a mean of 33.9 days between interventions. Coronavirus disease 2019 patients do not appear to respond as well to steroid, laser and balloon dilatation as other adult stenosis patients.ConclusionIntubated coronavirus disease 2019 patients have an increased risk of laryngotracheal stenosis, as a result of multiple factors. Otolaryngology teams should be vigilant in investigating for this complication. International guidelines on time to tracheostomy should be followed, despite a diagnosis of coronavirus disease 2019.
Cambridge University Press
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