Tracheal Stenosis

Tracheal stenosis is a narrowing of the windpipe that may cause difficulty breathing.  Tracheal stenosis can be something you are born with or acquire later in life.  This condition most commonly arises from having a breathing tube in place.  Tracheal stenosis can be diagnosed with imaging tests and bronchoscopy.

What is tracheal stenosis?

Tracheal stenosis is when the windpipe becomes narrowed from inflammation, scar tissue, or tumor.

Symptoms of tracheal stenosis

Tracheal stenosis can cause difficulty breathing, wheezing, chest congestion and infections.

What does tracheal stenosis look like on imaging?

Tracheal stenosis can be identified on an X-ray as a narrowed appearance of the tracheal air column.

This diagnosis can also be made on CT as a narrowed trachea.  There may be soft tissue thickening along the trachea which represents scar tissue or inflammation.

A mass causing narrowing of the trachea may represent a tumor.

Structures next to the trachea can also cause narrowing of the trachea.

Tracheal stenosis on MRI

MRI is rarely used for evaluation of the trachea.  Narrowing and soft tissue thickening of the trachea will be seen.

How is tracheal stenosis diagnosed?

The diagnosis can be made with imaging studies like CT.  Bronchoscopy is also used for diagnosis.  Bronchoscopy uses a tube with a lighted camera at the end to look at the airways including the trachea.

What causes tracheal stenosis?

Tracheal stenosis is most commonly caused by injury from a breathing tube or tracheostomy.

Other injuries like inhalation burn or external trauma.

Idiopathic or no clear cause is found.

Infections that can be bacterial or viral.

Inflammatory and autoimmune diseases can cause tracheal stenosis.

Tumors can cause narrowing of the trachea.

Structures which compress the trachea can cause stenosis.  Imaging can identify any external compression of the trachea.

Prior radiation therapy to the neck.

Is tracheal stenosis dangerous?

Tracheal stenosis can affect quality of life in children and adults by making it hard to breathe.  The condition may be life threatening in infants.

Is tracheal stenosis reversible?

It can be reversed with appropriate treatment.  Treating the underlying condition combined with endoscopic or surgical treatments can reverse the condition.

Is tracheal stenosis progressive?

It can be if the underlying cause of the tracheal stenosis is not treated.

Tracheal stenosis

Bronchoscopic tracheal dilation is used to stretch the trachea using a balloon or dilator. 

Laser bronchoscopy burns away scar tissue using a laser.

Airway stent: The narrowing in the trachea is kept open with a metal stent.

Surgery:  this involves removal of the scarring and narrowing of the trachea.  The remaining trachea is then connected together.

Tracheal stenosis: summary

Tracheal stenosis is a condition that you can be born with or can acquire.  A common cause of tracheal stenosis is from breathing tubes.  Tracheal stenosis can cause difficulties with breathing and infections.

Tracheal stenosis can be diagnosed on imaging studies like X-rays and CT.   Bronchoscopy is also often used for diagnosis.  Treatment is aimed at the underlying condition and to improve breathing.  Some of the endoscopic and surgical options are outlined above.