Tracheal Stenosis

The trachea, commonly called the windpipe, is the airway between your larynx (voice box) and your lungs. Tracheal stenosis is a narrowing of this airway, which restricts your ability to breathe normally.

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Symptoms

The symptoms of tracheal stenosis are similar to those of other conditions so it is important to see your doctor, particularly if you have experienced an injury to your throat. In addition to a feeling of fatigue or malaise, the symptoms of tracheal stenosis typically are:

  • Wheezing, coughing or shortness of breath, including difficulty breathing.
  • A high-pitched squeal coming from your lungs when you inhale.
  • Frequent bouts of pneumonia or upper respiratory infections.
  • Asthma that doesn’t respond well to treatment.
  • A blue color in the skin or mucous membrane of the mouth or nose.

Causes and Risk Factors

Though rare, tracheal stenosis may be present at birth. More commonly, the condition is the result of an injury or illness, such as

  • An external injury to the throat or chest.
  • Infections of a viral or bacterial nature, including tuberculosis.
  • An autoimmune disorder such as sarcoidosis, papillomatosis, Wegener's granulomatosis and amyloidosis.
  • Tumors, benign or malignant, which may press against the trachea, thereby restricting air flow.
  • Occasionally, tracheal stenosis may develop after radiation therapy to the neck or chest.
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Diagnosis

Your doctor will do a full work up and tests to assess your lung function. If your doctor suspects tracheal stenosis, one or more of the following tests may be ordered:

  • Lung function tests to measure respiratory function and determine blockages.
  • computed tomography (CT) scan of both your neck and chest.
  • chest X-ray, which will show the windpipe and your chest.
  • An endoscopic procedure, in which a tiny camera is inserted in your airway, to see inside the hollow cavity:
    • Bronchoscopy, which is used to examine airways for abnormalities such as tumors, bleeding and inflammation.
    • Laryngoscopy, which is used to view the vocal cords.
  • A biopsy to check on the malignancy of any tumors or lumps.
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Treatments

There are a number of options to treat tracheal stenosis. Which option your surgeon uses will depend on a number of factors, including the cause, location and extent of the narrowing. The surgeons at the Women’s Guild Lung Institute opt for minimally invasive techniques wherever possible although even those procedures require general anesthesia and a hospital stay.

The surgical techniques include:

  • Laser surgery, which can remove scar tissue, if that is what’s causing the stenosis. This provides short term relief but usually isn’t a long term solution.
  • Airway stenting, called tracheobronchial stenting, where a mesh like tube keeps the airway open.
  • Widening of the trachea, or tracheal dilation, where a small balloon or dilator is used to expand the airway. This also may not be a long term solution.
  • Full tracheal resection and reconstruction, which may provide long term relief. The damaged section of the trachea, windpipe, is removed and the remaining ends are joined.