2025 Volume 76 Issue 4 Pages 222-229
Tracheal stenosis after tracheotomy is a symptom that should be noted as a late complication of tracheotomy, but because it is relatively rare, its clinical characteristics have not been widely recognized. In this study, we report two cases of delayed tracheal stenosis after tracheotomy closure, together with their clinical characteristics. Both cases had a common feature of poor performance status (PS), but the literature also states that cases of tracheal stenosis after tracheotomy often have poor PS. It is important to note that patients with poor PS are less active and therefore less likely to be aware of dyspnea even if they have tracheal stenosis. When deciding on a treatment plan, it is important to place more importance on objective evaluations such as CT scans rather than subjective symptoms. The causes of delayed tracheal stenosis were examined based on intraoperative findings. In case 1, obesity and keloid constitution were thought to be the cause, and in case 2, thyroid enlargement of unknown cause was thought to be the cause. In both cases, airway fenestration was performed. In case 1, fenestration was performed using the trough method. In case 2, the neck could not be extended under local anesthesia, and the thyroid gland was significantly enlarged, so a tracheotomy was performed in conjunction with a cricoid cartilage incision, allowing the airway to be safely opened and the narrowed area relieved. Treatment for tracheal stenosis after tracheotomy differs depending on the cause and the patient's overall condition, so it is important to consider each case individually.
