Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis

Le résumé fourni par la source

• Despite the efficacy of reconstructive surgeries and Montgomery T-tube, clinical and neurological instability significantly impact outcomes and prolong tracheostomy use. • Treatment for post-intubation tracheal or laryngotracheal stenosis requires a multidisciplinary and personalized approach. • Dysphagia is a significant factor linked to poorer clinical outcomes and extended tracheostomy use. To investigate the clinical and swallowing profiles of patients with post-intubation tracheal or laryngotracheal stenosis requiring tracheostomy prior to surgical or corrective airway interventions. A retrospective cohort clinical study. Patients who met the inclusion criteria underwent a swallowing evaluation, as well as imaging studies of the neck and chest. At 6 and 12-months after the initial assessment, all patients participated in follow-up speech pathology consultations to evaluate the current state of swallowing and the progress of airway stenosis treatment. Twenty-five patients with a median tracheostomy duration of 30.52 months were assessed. The study found a female predominance (68%) and a high prevalence of subglottic stenosis (44%). Most patients required intubation due to severe acute respiratory failure and airway protection due to a decreased level of consciousness. Imaging revealed additional airway abnormalities, including laryngotracheobronchitis and laryngeal edema. Swallowing assessments showed that 20% had significant dysphagia. After one year, only two patients were successfully decannulated, while others remained tracheostomy dependent. The study underscores the need for personalized, multidisciplinary care for these patients. It finds that while treatments like reconstructive surgeries and the Montgomery T-tube can be effective, complications such as clinical instability and dysphagia can worsen outcomes and extend the need for tracheostomy.

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