Sténose trachéale chez les br슩lés : incidence et facteurs de risque.Ann Burns Fire Disasters 2019; 32(2):122-129AB
Tracheal stenosis remains frequent, especially in intensive care patients requiring prolonged intubation or tracheotomy. There is little data in the literature regarding this complication in burn patients. The aim of our study was to determine incidence, characteristics and risk factors of tracheal stenosis in burn patients. A retrospective study was conducted in a 20-bed burn ICU in Tunis over 7 years. It included all patients who presented tracheal stenosis confirmed by endoscopic and/or radiological exploration. Tracheal stenosis was confirmed in 15 patients with an overall incidence of 0.8% and an incidence of 3.5% in intubated patients. The mean age was 24 years, with TBSA of 28±15%. The burn was thermal in all patients. Facial burn was noted in all patients. Inhalation syndrome was observed in 12 patients. Duration of intubation was 16±12 days. Dyspnea, stridor and dysphonia were the most common symptoms. The onset of clinical signs was 30 days on average after extubation. All patients underwent bronchoscopy and/or cervico-thoracic scan for diagnosis. The average distance between the stenosis and vocal cords was 27 mm and the average degree of stenosis was 68%. The average length was 20 mm. Therapeutic management was based on: dilation in 3 cases, Montgomery tracheal T-tube insertion in 2 cases, and endoscopic laser therapy in 3 cases. Tracheal resection-anastomosis was performed in 5 patients. The evolution was favorable in 8 patients. Restenosis was observed in 2 patients. Five patients died. Inhalation injury, facial burn and prolonged intubation were recognized as risk factors that increase the likelihood of this complication.