Vasanthan Rishi, Sorooshian Parviz, Sri Shanmuganathan Vishnu, Al-Hashim Muhannad
Department of Head and Neck Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
Department of Plastic Surgery, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
J Surg Case Rep. 2021 Jan 18;2021(1):rjaa569. doi: 10.1093/jscr/rjaa569. eCollection 2021 Jan.
Laryngotracheal stenosis (LTS) is a rare but serious condition characterized by narrowing of the airway. Iatrogenic injury from endotracheal intubation or tracheostomy insertion is the most common cause of LTS. We present the first reported experience of managing a patient diagnosed with subglottic stenosis (a subtype of LTS) following previous intubation and tracheostomy for coronavirus disease 2019 (COVID-19). This patient required an urgent surgical tracheostomy and subsequent referral to a tertiary airway surgery unit for definitive treatment, which included microlaryngoscopy, laser excision and balloon dilatation. This case highlights that LTS should be included in the differential diagnosis for patients re-presenting with breathing difficulties after prolonged intubation or tracheostomy for COVID-19. Furthermore, it raises the concern of a rise in the incidence of this condition and an increased burden on the few units specializing in airway surgery.
喉气管狭窄（LTS）是一种罕见但严重的疾病，其特征为气道狭窄。气管插管或气管切开术造成的医源性损伤是LTS最常见的病因。我们报告了首例确诊为声门下狭窄（LTS的一种亚型）患者的治疗经验，该患者此前因2019冠状病毒病（COVID-19）接受过插管和气管切开术。该患者需要紧急行外科气管切开术，随后转诊至三级气道外科单位进行确定性治疗，包括显微喉镜检查、激光切除和球囊扩张。该病例凸显出，对于因COVID-19长时间插管或气管切开术后再次出现呼吸困难的患者，应将LTS纳入鉴别诊断。此外，这引发了对该疾病发病率上升以及少数气道外科专科单位负担加重的担忧。
