Prolonged intubation increases risk for which airway complication?

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

Answer: (C)

Prolonged intubation injures the subglottic region, which is the narrowest part of a child’s airway and most susceptible to tube-related trauma. The endotracheal tube exerts continuous pressure on the inferior larynx; if this pressure is sustained, it compromises blood flow to the mucosa and underlying tissues, causing ischemia, ulceration, and the formation of granulation tissue. As healing occurs, scar formation narrows the airway just below the vocal cords, leading to subglottic stenosis. This is a classic consequence of long-term intubation in pediatrics.

Other conditions listed are not typically caused by prolonged intubation. Laryngomalacia is a congenital floppy supraglottic tissue problem; epiglottitis is an acute infection of the epiglottis; croup is usually a viral inflammation of the larynx and subglottic area. The key link is the injury and scarring in the subglottic region from extended tube use.