Airway injury after tracheotomy and endotracheal intubation.

Iatrogenic airway injury after tracheotomy and endotracheal intubation continues to be a serious clinical problem. Endotracheal tubes cause pressure injury to the glottis and may result in severe commissural scarring that is difficult to treat. Tracheotomy tubes may result in severe stomal stenosis in the trachea or subglottic region, which is more amenable to surgical treatment. Both methods of airway intubation may result in pressure necrosis from the tube cuff that can be prevented by careful monitoring of inflation pressures. The technique of laryngotracheal resection and reconstruction has been well developed and may be applied successfully to most patients with subglottic and tracheal stenosis. The surgical treatment of glottic stenosis remains a challenge.