Tracheal Stenosis Treatment

About the disease

Tracheal stenosis is the narrowing of the trachea, commonly known as the windpipe, which transports air to the lungs. This is a very rare condition, affecting 1 out of 200,000 people every year. It usually develops in adults, particularly those who suffer from chronic inflammatory diseases that affect the pulmonary function. It can also develop as a result of previous tracheal surgery. There are two main types of pulmonary stenosis:

• Laryngeal
• Upper tracheal

Laryngeal stenosis is thought to be more common than pulmonary stenosis. The main manifestation of tracheal stenosis is ulceration of the trachea, an inability to breathe fully and pain in the lungs. In some cases, scar tissue can develop as well. The most common cause of tracheal stenosis is pulmonary trauma, which can be either internal or external. Internal trauma includes previous surgery on the trachea and irradiation and tracheal burns. External trauma includes trauma of the neck or prolonged intubation. 

In people with tracheal stenosis, dyspnea can develop. Dyspnea is breathlessness that can last several moments and may be diagnosed if someone is often unable to breathe properly even though they are not physically exerting themselves.

Symptoms

• Pain in the lungs
• Inability to breathe fully
• Sores
• Ulcers
• Dizziness
• Headache

Diagnosis

• During a general examination, the doctor will listen to the patient's lungs for signs of possible wheezing or stridor, which can indicate tracheal stenosis. Nonetheless, since these symptoms are often mistaken for asthma, it is important that additional diagnostic methods are performed if an accurate diagnosis is to be made.
• An X-ray of the trachea can show if there are any signs of narrowing.

Treatment

• Resection and plastic repair with end-to-end anastomosis is a surgical procedure whereby the narrowed section of the trachea is removed and the remaining ends are joined together, or a prosthetic replaces the piece that was removed, thereby reinstating the patient’s full breathing capacity.  This surgery is proposed in severe cases of tracheal stenosis.
• Stenting is a surgical procedure whereby a stent is placed into the trachea in order to widen it and keep it open, so that air can reach the lungs. 
• Balloon dilation is a surgical procedure whereby a balloon is used to dilate the trachea, thereby normalizing the patient’s breathing. This surgery is proposed in mild cases of tracheal stenosis.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko