Subtle Signs, Serious Consequences: The Overlooked Progression of Laryngotracheal Stenosis – A Case Series

Postintubation laryngotracheal stenosis is a potentially life-threatening but often underdiagnosed complication following prolonged endotracheal intubation. It typically presents weeks after extubation with nonspecific respiratory symptoms such as dyspnea, wheezing, or stridor, frequently mimicking asthma or chronic obstructive pulmonary disease. This case series describes four patients who developed significant tracheal stenosis following prolonged intubation for critical illness and trauma, respectively. These cases demonstrated granulation tissue and luminal narrowing on bronchoscopy, consistent with Grade III stenosis as per the Cotton–Myers classification. This report emphasizes the importance of clinical suspicion, early diagnosis using imaging and bronchoscopy, and a multidisciplinary approach to management. Regular monitoring of endotracheal tube cuff pressure is critical in preventing this avoidable complication.