Interventional treatment of post tracheostomy tracheal stenosis in neurological rehabilitation: results of a single-center registry

Introduction: Post tracheostomy tracheal stenosis (PTTS) is a serious long-term complication of tracheostomies. PTTS can significantly delay respiratory weaning, impair the patient's quality of life and cause significant healthcare costs. There do not exist any standardized treatment recommendations for PTTS. The aim of the present study was to improve knowledge regarding PTTS treatment and the associated clinical course. Methods: Consecutive patients who were admitted in an intensive care unit (ICU) of a German neurological specialist hospital from 30.04.2020 to 10.11.2025 were included in a single-center, combined retro- and prospective registry. Results: 132 patients (50.8% female, mean age: 67 years) underwent a total of 198 interventions (mean: 1.5) for the treatment of PTTS. Most patients (68.2%) were treated only once. Cryoablation was the most performed intervention. 70.5% of patients were treated with prednisolone, which was sufficient alone in 30.1% of these patients. 77.3% of patients could be decannulated after PTTS treatment, 17.4% were discharged with a permanent tracheostoma mainly due to their severe neurological condition and 4.6% died during the hospital stay. Mean follow-up was 68 days. Only 2.3% of patients underwent surgical PTTS treatment and 0.8% were in need for an airway stent. All interventions were performed without procedure-associated complications. Conclusion: Interventional treatment of PTTS in neurological rehabilitation appears to be effective in enabling decannulation, and safe.