110 C. Percul et al. CIRUGÍA PEDIÁTRICA Abstract Objective. Considering that intubation time is the primary cause of subglottic stenosis, tracheostomy is suggested in adult patients following 10-15 days. The objective of this study was to analyze the association between intubation time and stenosis in pediatric patients, as well as to establish whether there is an adequate timing for tracheostomy in order to reduce the incidence of stenosis. Materials and methods. A retrospective study (2014-2019) of tracheostomized newborns and children after an intubation period was carried out. Endoscopic fndings at tracheostomy were analyzed. Results. Tracheostomy was conducted in 189 patients, 72 of whom met inclusion criteria. Mean age was 40 months (1 month - 16 years). The incidence of stenosis was 21%, with a mean age of 23 months and a mean intubation time of 30 days vs. 19 days in the non-stenosis group (p= 0.02). The incidence of stenosis increased by 7% fve days following intubation, reaching 20% after one month. Patients under 6 months old had greater tolerance to intubation pe- riods without stenosis (incidence < 6% after 40 days, and median time to stenosis of 56 days vs. 24 days in patients over 6 months old). Conclusions. In patients with long intubation periods, preventive measures should be taken in order to avoid laryngotracheal injuries, and early tracheostomy should be considered. Key Words: Tracheal stenosis; Tracheostomy; Laryngostenosis; Intubation. Asociación entre estenosis subglótica e intubación endotraqueal en pacientes pediátricos traqueostomizados Objetivos. Considerando el tiempo de intubación la principal causa de estenosis subglótica, en adultos se sugiere realizar una traqueostomía a los 10-15 días. Se buscó determinar la asociación entre tiempo de intubación y estenosis en pediatría y establecer si existe, un momento en el que realizar una traqueostomía reduciría la incidencia de estenosis. Material y métodos. Estudio retrospectivo (2014-2019) de neo- natos y niños traqueostomizados luego de un período de intubación. Se analizaron los hallazgos endoscópicos al realizar la traqueostomía. Resultados. Se traqueostomizaron 189 pacientes y 72 cum- plieron criterios de inclusión. La edad media fue de 40 meses (1 mes a 16 años). La incidencia de estenosis fue de 21%, con edad media de 23 meses e intubación media de 30 días versus en el grupo sin estenosis fue de 19 días (p= 0 ,02). La incidencia de estenosis aumentó un 7% a los cinco días de intubación alcanzando el 20% al mes. Los menores de 6 meses presentaron mayor tolerancia a períodos de intubación sin estenosis (incidencia <6% luego de 40 días y mediana de tiempo hasta la estenosis de 56 días, versus 24 días en mayores de 6 meses). Conclusiones. En pacientes con intubación prolongada, se de- ben tomar medidas preventivas para evitar el desarrollo de lesiones laringotraqueales incluyendo la consideración de una traqueostomía temprana. Palabras Clave: Estenosis traqueal; Traqueostomía; Laringoes- tenosis; Intubación. INTRODUCTION Airway injuries following endotracheal intubation rep- resent a severe problem in pediatrics. Subglottic stenosis has a reported incidence of 0.9-8.3% (1,2) . Even though laryngo- tracheal stenosis can be of congenital origin, it is acquired in more than 90% of cases, with endotracheal intubation being the primary etiological factor directly related to it (3) . The development of this pathology is impacted by multiple factors, such as traumatic intubation, tube size, presence of balloon, and intubation time, as well as other patient-related factors such as low weight at birth, pre- maturity, associated infections, immunosuppression, and gastroesophageal refux (2-6) . Various publications have demonstrated that endotra- cheal intubation time is a key factor in the etiopathogenesis Original Article Association between subglottic stenosis and endotracheal intubation in tracheostomized pediatric patients C. Percul, L. Lerendegui, P. Lobos, D. Liberto, J. Moldes, M.M. Urquizo Pediatric Surgery and Urology Department. Hospital Italiano de Buenos Aires. Buenos Aires (Argentina). Cir Pediatr. 2023; 36: 110-115 DOI: 10.54847/cp.2023.03.10 Corresponding author: Dr. Carolina Percul. Hospital Italiano de Buenos Aires, Tte. General Juan Domingo Perón, 4190. C 1199 CABA (Argentina) E-mail address: carolina.percul@italianhospital.org.ar This research has received no external funding whatsoever. This work was partially presented at the Argentinian Pediatric Surgery Congress held in Rosario (Argentina) in October 2021. Date of submission: January 2023 Date of acceptance: June 2023