Posterior commissure stenosis post long-term intubation.

A prospective study of 200 patients having long-term endotracheal intubation has been completed. This study has defined the events in stenosis evolution for the two varieties of scarring in the posterior commissure of the larynx. An overall stenosis incidence of 6% for this long-term intubated patient population has been found. In the majority of patients the posterior commissure stenosis is a component of more complex injury. The importance of tube tissue interfacing in the posterior commissure and the role of ongoing movement of both a shearing and blunt nature is of increasing significance as intubation time lengthens. Changing the character of this interface by the addition of a small posterior air cushion on the endotracheal tube can minimize ongoing trauma in the posterior endolarynx.