Tracheal stenosis is the abnormal narrowing of the trachea.  The trachea, also known as the windpipe, is the airway between the voice box and the lungs.  Tracheal stenosis restricts the ability to breathe normally.  Cases can be very mild or severe.  Tracheal stenosis can be congenital, present since birth, or caused by injury.  

Causes

There are many causes of Tracheal stenosis.  It can be caused by trauma to the throat.  Infections like tuberculosis can also be a cause.  Autoimmune disorders like sarcoidosis, or papillomatosis can cause Tracheal stenosis.  Tumors either benign or malignant can also cause narrowing in the trachea.  Swelling, Wegener’s granulomatosis, or inhalation burns are all causes as well.  Congenital malformations are a birth defect that cause congenital Tracheal stenosis.  Another cause of Tracheal stenosis is having a breathing tube placed for a long amount of time.  Some things can heighten the risk or chances of Tracheal stenosis after a breathing tube is placed; female, overweight, diabetic, hypertension, heart disease, or a current smoker.  

 

Symptoms

Symptoms can be mild or severe.  Some mild symptoms may not ever go diagnosed.  Symptoms can include shortness of breath when resting, or after exercising.   Increased effort to breathe. Constant cough or congestion.  Respiratory sounds such as wheezing, or a high pitched sound.  Frequent cases of pneumonia or upper respiratory infections.  The skin around the mouth, nose or gums is blue.  Mucous membrane of mouth or nose.  Feeling of phlegm stuck in the throat.  Pauses in breathing, or apnea.  You could also suffer from choking or trouble breathing when eating.  With difficulty breathing another symptom could be tiring easily.  

 

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Diagnosis

Diagnosis will start with a physical evaluation from your doctor.  Your doctor will want to listen to your breath sounds.  Afterwards they will probably want to do other tests to verify how bad the narrowing of the trachea is.  Your doctor may want to do a lung functioning test.  This test will measure lung function, capacity, rate of flow, and gas exchanges.  A CT scan of the neck or chest or a chest Xray may also be able to show the narrowing of the trachea.  Your doctor may want to take a look at your trachea closer by using an endoscopic procedure.  A bronchoscopy is when the doctor will use a camera to pass into the airway.  Another endoscopic procedure is laryngoscopy.  The only trouble with endoscopic procedures is that using a scope may constrict the airway even more.  If there is a mass in your trachea, your doctor may want to biopsy the mass. 

 

Treatment

Treatment can sometimes be minimally invasive depending on how severe.  Laser therapy to remove scar tissue can be done when a tracheal tube was used for a long time.  This is not usually a long term fix.  Another treatment that may not be long term is a tracheal dilation.  This is when a balloon is inserted into the airway.  The balloon is expanded to open up the airway.  Tracheobronchial stenting may be a good treatment option.  A doctor will place a mesh tube that keeps the airway open.  Tracheal resection and reconstruction is another treatment option.  This is where your trachea is cut on either side of the narrowing, then reconnected.  A trachea organ transplant can also be an option.  A last resort is to have a tracheostomy done, where a tube is put into your throat to help you breathe.  This is only in severe cases where no other treatment is working.

 

Tracheal stenosis does not have to be fatal if treatment is seeked.  If no treatment is done and symptoms are severe Tracheal stenosis can be fatal.  Symptoms can worsen over time if the narrowing of the trachea worsens.  Even after certain treatment options have been taken you will still need follow up appointments to make sure the narrowing doesn’t start happening again. 

 

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A constant cough or congestion can be a sign of a problem in the trachea!



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