Prevalence and predictors of laryngotracheal stenosis at Chris Hani Baragwanath Academic Hospital

Abstract

Objective: The purpose of the research was to determine the prevalence and predictors of laryngotracheal stenosis at Chris Hani Baragwanath Academic Hospital.

Method: The research design was a retrospective cross-sectional study of 955 patients admitted into the ear, nose and throat department at Chris Hani Baragwanath Academic Hospital from 2010-2016. Demographic information, medical and surgical history, and clinical findings were examined. Inclusion criteria included 100 patients who were managed for laryngotracheal stenosis secondary to prolonged intubation. Patients with laryngotracheal stenosis from other causes such as caustic ingestion, congenital laryngotracheal stenosis, idiopathic laryngotracheal stenosis, and malignancy related laryngotracheal stenosis were excluded. Demographic data was analysed using descriptive statistics, while hypotheses were tested using multiple regression models.

Results: Out of 955 patients, 100 had been diagnosed with laryngotracheal stenosis, indicating a 10.47% prevalence rate. Patients who were diagnosed were mainly from the 26-30 age group, constituting 31%, followed by the 16-20 age group (21%), less than 1-years (19%), and the 2125 age group (14%). The study showed that 65% men and 35% female were diagnosed with laryngotracheal stenosis. Severity levels among the studied population indicated that all patients fell under Myers-Cotton 1 to 3, with the majority in Myers-cotton 3 (85%). Multiple regression models indicated that maturity level, patient sex, indication for intubation and the intubating discipline, had no significant influence on the grades of laryngotracheal stenosis.

Conclusion: The research highlights the high prevalence rates of laryngotracheal stenosis. In order to reduce the high prevalence, this study recommends close adherence to guidelines regarding cuff pressure monitoring and selection of appropriate sized endotracheal tubes.