History of prolonged intubation increases risk for which airway condition?

• A. Epiglottitis
• B. Subglottic stenosis
• C. Laryngotracheobronchitis
• D. Croup

Answer: (B)

Prolonged intubation injures the part of the airway just below the vocal cords, the subglottic region. In children this area is the narrowest part of the airway, so pressure from the tube and its cuff can cause mucosal ischemia, ulcers, granulation tissue, and ultimately scar formation that narrows the lumen. That scar tightening is called subglottic stenosis, and it’s a classic delayed complication after a long period of intubation.

Epiglottitis is an acute infection of the epiglottis and presents with sudden drooling and severe distress, not related to prior intubation. Croup (laryngotracheobronchitis) is typically a viral illness causing a barking cough and inspiratory stridor, also not linked to a history of prolonged intubation. Laryngotracheobronchitis is basically another name for croup. So the history of prolonged intubation most directly points to subglottic stenosis.