Commentary Open Access
Volume 2 | Issue 2 | DOI: https://doi.org/10.33696/pathology.2.018

Identification of Laryngotracheal Stenosis During Weaning from Tracheostomy – A Clinical Conundrum

  • 1Highly Specialist Physiotherapist, Adult Critical Care Unit, Royal London Hospital, London, UK
  • 2Highly Specialist Speech and Language Therapist, Adult Critical Care Unit, Royal London Hospital, London, UK
  • 3Clinical Specialist Physiotherapist, Critical Care Outreach Team, The Royal London Hospital, London, UK
+ Affiliations - Affiliations

Corresponding Author

Amanda Jane Thomas, Amanda.Thomas21@nhs.uk

Received Date: March 17, 2021

Accepted Date: April 20, 2021


Laryngotracheal stenosis is an umbrella term for narrowing of the airway, which may occur at the level of the larynx, subglottic or trachea. Identification of laryngotracheal stenosis prior to decannulation poses a clinical conundrum. Subglottic stenosis is commonly reported as a symptom of laryngeal injury following endotracheal intubation. Readiness for tracheostomy decannulation varies between institutions, and lacks international consensus. Detection of laryngotracheal stenosis prior to decannulation typically involves invasive visualization of the airway using nasendoscopy or exposure to radiation for computerized tomography. Ultrasound is a non-invasive bedside diagnostic tool, available in most intensive care units and its portable nature promotes wider clinical utilization. Ultrasonography is employed to identify abnormal physiology, assist clinical examination and decision making and is well established for point of care lung assessment and echocardiography. There is increasing interest in ultrasound development for diagnostic and monitoring purposes, due to its safety, lack of radiation, rapid application, and real-time dynamic feedback. This narrative explores the consideration of laryngeal ultrasound in the context of tracheostomy weaning, a modality that has a promising role in detecting subglottic stenosis.


Tracheostomy, Decannulation, Subglottic stenosis, Ultrasound, Laryngotracheal Stenosis, Laryngeal Injury

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