Research Article
Aetiopathogenesis of Laryngotracheal Stenosis:
A Retrospective Review
Bigyan Raj Gyawali , Rabindra Bhakta Pradhananga, Kunjan Acharya ,
Heempali Dutta, Yogesh Neupane, Dharma Kanta Baskota, and Rajendra Guragain
Department of ENT-HNS, Maharajgunj Medical Campus, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal
Correspondence should be addressed to Bigyan Raj Gyawali; bigyan.gyawali@gmail.com
Received 25 August 2019; Revised 1 August 2020; Accepted 29 August 2020; Published 22 September 2020
Academic Editor: Gerd J. Ridder
Copyright © 2020 Bigyan Raj Gyawali et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Airway stenosis is a technically challenging pathology to deal with. Various aetiologies can lead to the stenosis;
however, trauma, mostly related to intubation, is the commonest so far. is study retrospectively evaluates various aetiological
factors resulting in airway stenosis and the associated patient-related factors. Objectives. e objectives of this study were to
evaluate the common patient-related factors, aetiology, site, and mode of presentation of airway stenosis and to evaluate the
duration of intubation resulting in airway stenosis. Materials and methods. is was a retrospective study carried out at the
Department of ENT-HNS, Institute of Medicine, Nepal. Record files from January 2014 to January 2019 of all cases with en-
doscopic diagnosis of airway stenosis were evaluated. Demographic data, site, severity, aetiology, time, and mode of presentation
were noted. e severity of stenosis was graded based on Cotton–Meyer (CM) classification. Results. A total of 33 cases were
included in the study. e trachea and the subglottis were the frequent sites to be involved. Intubation-related trauma was the
commonest aetiology with a shortest duration of intubation of only 4 days resulting in development of the stenosis. e other
aetiologies were congenital, trauma, inflammation, and idiopathic. Conclusion. Trauma, mostly related to intubation, is still the
commonest cause for the development of airway stenosis. Along with the duration of intubation, there are several other factors
that can affect the development of stenosis. A prospective study with a large population is required to draw a definite conclusion.
1. Introduction
Airway stenosis is one of the challenging pathologies to treat
in the field of otorhinolaryngology. It can be at the level of
supraglottis, glottis, subglottis, or trachea. Of the wide range
of aetiologies described, e.g., congenital, traumatic, in-
flammatory, and idiopathic [1, 2], trauma following pro-
longed intubation and tracheostomy is still considered the
commonest aetiology for the development of airway stenosis
in both paediatric [3] and adult population [2, 4]. Aetio-
logical factors, however, may vary in their prevalence in
different geographical regions. As stated by Gelbard et al.,
airway stenosis is an anatomical definition with a diverse
pathogenesis. Moreover, various patient factors are known
to affect the development of the stenosis, e.g., gender,
obesity, and type II DM [2, 5]. Considering the fact, the
management strategy for this entity should be tailored on an
individual basis.
e study retrospectively evaluates a unique cohort of
Nepalese population with documented laryngotracheal
stenosis for the common patient-related factors such as age,
sex and comorbid conditions, aetiology, site and mode of
presentation, and the duration of intubation resulting in
airway stenosis.
2. Materials and Methods
is was a retrospective study carried out at the Department
of ENT-HNS, Institute of Medicine, Nepal. Approval for the
study was taken from the Institutional Review Committee.
All cases with the endoscopic diagnosis of airway stenosis
were included in the study, and the records lacking the
Hindawi
International Journal of Otolaryngology
Volume 2020, Article ID 1941046, 6 pages
https://doi.org/10.1155/2020/1941046