Table of ContentsView AllTable of ContentsIncidenceSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Incidence
Symptoms
Diagnosis
Treatment
Tracheal stenosis is a narrowing of yourtrachea, or windpipe, due to the formation of scar tissue or malformation of the cartilage in the trachea. While mild narrowing in your trachea may never be identified, a significant narrowing of more than 50% of your airway can lead to serious complications.The ttwo most prevalent causes of tracheal stenosis are:
Other known causes include:
In cancer and congenital malformations, the airway is being compressed either from outside the trachea or from narrowing from malformed cartilage.
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Other causes of tracheal stenosis usually start with an ulceration in the trachea. The ulceration starts a cascade ofinflammation, which is a normal healing process that can become exaggerated and may cause more scar tissue than would normally be necessary. This additional scar tissue narrows the area in your trachea.
The frequency of acquiring tracheal stenosis depends upon the cause of the tracheal narrowing.Post-intubationdamage to the airway can be common; however, the risk of symptomatic stenosis is low. The following risk factors will increase your likelihood of having post-intubation or tracheostomy-related tracheal stenosis:
Tracheal stenosis may be one of the first signs seen in granulomatosis with polyangiitis. Stenosis can occur about 20% of the time. There is not much data available on the prevalence of other causes of tracheal stenosis.
In congenital tracheal stenosis, mild stenosis can often be misinterpreted as asthma or recurrent bronchitis.With mild tracheal stenosis, you may not identify symptoms until later childhood or early adolescence when symptoms appear as difficulty breathing with exercise. In more severe cases of congenital tracheal stenosis, you may notice the following symptoms:
In other cases of acquired tracheal stenosis, the symptoms may not present themselves for several weeks after the injury occurs.Difficulty with breathing is the common first symptom. Like congenital tracheal stenosis, you may notice stridor, wheezing, or exertional shortness of breath.
Several testing methods may be used to help your healthcare provider determine whether you have tracheal stenosis or not. Bronchoscopy is considered the gold standard for diagnosing tracheal stenosis because your healthcare provider will be able to directly visualize your trachea.
However, there are some risks associated with this because using a scope will further obstruct your airway, so maintaining your oxygenation levels may be more difficult. Discuss your individualized risk factors associated with bronchoscopy with your healthcare provider.
Other methods that your healthcare provider may use include X-ray, CT scan, ultrasound, MRI, and pulmonary function testing. Standard X-rays are good at the identification of structure, columns of air, trauma, and other preliminary data.Other more sophisticated X-ray machines can be used (xeroradiography) to further identify stenosis; however, the radiation exposure is significantly higher than other methods.
Computed Tomography (CT) Scans
CT scanning can be a great technique for your healthcare provider in determining whether you have tracheal stenosis or not.It does, however, have difficulty identifying soft tissue causes of the narrowing of your trachea. Some techniques are being utilized in a way to create “virtual endoscopy” to minimize the need for you to undergo a bronchoscopy.
Ultrasound
Magnetic Resonance Imaging (MRI) Scans
MRIscanning is also a great alternative method to help in diagnosing tracheal stenosis, and in children, it is being considered to become a standard method. The major drawback of MRI is the length of time you need to commit to have the procedure done and the blurring that can occur from normal breathing during the exam. Improved techniques are continuously being developed to improve the utilization of this technique in diagnosing tracheal stenosis.
Pulmonary Function Testing (PFT)
Pulmonary function testing can be performed in some healthcare providers' offices, or if unavailable, you will be sent to a pulmonary lab. This test can be used to determine how much of an impact the stenosis is having obstructing your breathing.This will be helpful in discussions regarding treatment options with your practitioner.
Most treatments are endoscopic procedures requiring actual visualization of your trachea. If the area of stenosis is small, placing a stent, dilating your trachea with a balloon, or removing some of the scar tissue with a laser will help to minimize the stenosis.
During these procedures, your healthcare provider may also inject the tissue in your trachea with steroids to help minimize any swelling. Although often initially successful, there can be a high rate of recurrence with some of these procedures.
Tracheal Resection
This procedure is reserved for when endoscopic treatments have failed, or tracheal stenosis is too severe for endoscopic procedures.During this procedure, your healthcare provider will cut out the part of the trachea that is affected and repair your trachea with skin or cheek tissue.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Raman T, Chatterjee K, Alzghoul BN, et al.A bronchoscopic approach to benign subglottic stenosis.SAGE Open Med Case Rep. 2017;5:2050313X17713151. doi:2050313X17713151Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J.Causes and consequences of adult laryngotracheal stenosis.Laryngoscope. 2015;125(5):1137-43. doi:10.1002/lary.24956Blackabey V, Gan RWC, Buglass H, Kaul V, Ward VMM.Granulomatosis with polyangiitis causing subglottic stenosis-two cases and their management.AME Case Rep. 2018;2:17. doi:10.21037/acr.2018.03.01D’andrilli A, Venuta F, Rendina EA.Subglottic tracheal stenosis.J Thorac Dis. 2016;8:S140-7. doi:10.3978/j.issn.2072-1439.2016.02.03Yokoi A.Congenital tracheal stenosis: what should we look at for successful tracheoplasty?Transl Pediatr. 2018;7(3):229-232. doi:10.21037/tp.2018.07.01Desuter G, Gregoire A, Gardiner Q, Houssiau F.Hydroxychloroquine as treatment for inflammatory subglottic stenosis: a second successful case.Case Rep Otolaryngol. 2012;2012:754308. doi:10.1155/2012/754308Ezemba N, Echieh CP, Chime EN, et al.Postintubation tracheal stenosis: surgical management.Niger J Clin Pract. 2019;22(1):134-137. doi:10.4103/njcp.njcp_288_18Liu J, Zhang CP, Li Y, Dong S.Post-intubation tracheal stenosis after management of complicated aortic dissection: a case series.J Cardiothorac Surg. 2015;10:148. doi:10.1186/s13019-015-0357-zSongu M, Ozkul Y.Risk factors for adult postintubation tracheal stenosis.J Craniofac Surg. 2019;30(5):e447-e450. doi:Farzanegan R, Farzanegan B, Alehashem M, et al.Item selection and content validity of the risk factors of post-intubation tracheal stenosis observation questionnaire for ICU-admitted patients.Tanaffos. 2017;16(1):22-33.Irwin RS.Evaluation of wheezing illnesses other than asthma in adults. UpToDate.Hofferberth SC, Watters K, Rahbar R, Fynn-thompson F.Management of congenital tracheal stenosis.Pediatrics. 2015;136(3):e660-9. doi:10.1542/peds.2014-3931Hyzy RC.Complications of the endotracheal tube following initial placement: prevention and management in adult intensive care unit patients. UpToDate.Paradis TJ, Dixon J, Tieu BH.The role of bronchoscopy in the diagnosis of airway disease.J Thorac Dis. 2016;8(12):3826-3837. doi:10.21037/jtd.2016.12.68Lee KH, Kang ES, Jung JW, Park JH, Choi YG.Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report.Korean J Anesthesiol. 2013;65(3):254-6. doi:10.4097/kjae.2013.65.3.254Radiopaedia.Tracheal stenosis.Adali F, Uysal A, Bayramoglu S, Guner NT, Yilmaz G, Cimilli T.Virtual and fiber-optic bronchoscopy in patients with indication for tracheobronchial evaluation.Ann Thorac Med. 2010;5(2):104-9. doi:10.4103/1817-1737.62474Votruba J, Zemanová P, Lambert L, Vesela MM.The role of airway and endobronchial ultrasound in perioperative medicine.Biomed Res Int. 2015;2015:754626. doi:10.1155/2015/754626Johns Hopkins Medicine Health Library.Pulmonary function tests.Memorial Sloan Kettering Cancer Center.Treatment of tracheal stenosis.Auchincloss HG, Wright CD.Complications after tracheal resection and reconstruction: prevention and treatment.J Thorac Dis. 2016;8(Suppl 2):S160-7. doi:10.3978/j.issn.2072-1439.2016.01.86Additional ReadingAxtel, AL & Mathisen, DJ. Current Surgical Therapy: The Management of Tracheal Stenosis. 882-887.Patel, HH, Goldenberg, D & McGinn, JD. Cummings Otolaryngology: Surgical Management of Upper Airway Stenosis. 2015;68:982-992.e2.Waizel-Haiat, S. Tracheal Stenosis Imaging.http://emedicine.medscape.com/article/362175-overview
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Raman T, Chatterjee K, Alzghoul BN, et al.A bronchoscopic approach to benign subglottic stenosis.SAGE Open Med Case Rep. 2017;5:2050313X17713151. doi:2050313X17713151Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J.Causes and consequences of adult laryngotracheal stenosis.Laryngoscope. 2015;125(5):1137-43. doi:10.1002/lary.24956Blackabey V, Gan RWC, Buglass H, Kaul V, Ward VMM.Granulomatosis with polyangiitis causing subglottic stenosis-two cases and their management.AME Case Rep. 2018;2:17. doi:10.21037/acr.2018.03.01D’andrilli A, Venuta F, Rendina EA.Subglottic tracheal stenosis.J Thorac Dis. 2016;8:S140-7. doi:10.3978/j.issn.2072-1439.2016.02.03Yokoi A.Congenital tracheal stenosis: what should we look at for successful tracheoplasty?Transl Pediatr. 2018;7(3):229-232. doi:10.21037/tp.2018.07.01Desuter G, Gregoire A, Gardiner Q, Houssiau F.Hydroxychloroquine as treatment for inflammatory subglottic stenosis: a second successful case.Case Rep Otolaryngol. 2012;2012:754308. doi:10.1155/2012/754308Ezemba N, Echieh CP, Chime EN, et al.Postintubation tracheal stenosis: surgical management.Niger J Clin Pract. 2019;22(1):134-137. doi:10.4103/njcp.njcp_288_18Liu J, Zhang CP, Li Y, Dong S.Post-intubation tracheal stenosis after management of complicated aortic dissection: a case series.J Cardiothorac Surg. 2015;10:148. doi:10.1186/s13019-015-0357-zSongu M, Ozkul Y.Risk factors for adult postintubation tracheal stenosis.J Craniofac Surg. 2019;30(5):e447-e450. doi:Farzanegan R, Farzanegan B, Alehashem M, et al.Item selection and content validity of the risk factors of post-intubation tracheal stenosis observation questionnaire for ICU-admitted patients.Tanaffos. 2017;16(1):22-33.Irwin RS.Evaluation of wheezing illnesses other than asthma in adults. UpToDate.Hofferberth SC, Watters K, Rahbar R, Fynn-thompson F.Management of congenital tracheal stenosis.Pediatrics. 2015;136(3):e660-9. doi:10.1542/peds.2014-3931Hyzy RC.Complications of the endotracheal tube following initial placement: prevention and management in adult intensive care unit patients. UpToDate.Paradis TJ, Dixon J, Tieu BH.The role of bronchoscopy in the diagnosis of airway disease.J Thorac Dis. 2016;8(12):3826-3837. doi:10.21037/jtd.2016.12.68Lee KH, Kang ES, Jung JW, Park JH, Choi YG.Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report.Korean J Anesthesiol. 2013;65(3):254-6. doi:10.4097/kjae.2013.65.3.254Radiopaedia.Tracheal stenosis.Adali F, Uysal A, Bayramoglu S, Guner NT, Yilmaz G, Cimilli T.Virtual and fiber-optic bronchoscopy in patients with indication for tracheobronchial evaluation.Ann Thorac Med. 2010;5(2):104-9. doi:10.4103/1817-1737.62474Votruba J, Zemanová P, Lambert L, Vesela MM.The role of airway and endobronchial ultrasound in perioperative medicine.Biomed Res Int. 2015;2015:754626. doi:10.1155/2015/754626Johns Hopkins Medicine Health Library.Pulmonary function tests.Memorial Sloan Kettering Cancer Center.Treatment of tracheal stenosis.Auchincloss HG, Wright CD.Complications after tracheal resection and reconstruction: prevention and treatment.J Thorac Dis. 2016;8(Suppl 2):S160-7. doi:10.3978/j.issn.2072-1439.2016.01.86Additional ReadingAxtel, AL & Mathisen, DJ. Current Surgical Therapy: The Management of Tracheal Stenosis. 882-887.Patel, HH, Goldenberg, D & McGinn, JD. Cummings Otolaryngology: Surgical Management of Upper Airway Stenosis. 2015;68:982-992.e2.Waizel-Haiat, S. Tracheal Stenosis Imaging.http://emedicine.medscape.com/article/362175-overview
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Raman T, Chatterjee K, Alzghoul BN, et al.A bronchoscopic approach to benign subglottic stenosis.SAGE Open Med Case Rep. 2017;5:2050313X17713151. doi:2050313X17713151Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J.Causes and consequences of adult laryngotracheal stenosis.Laryngoscope. 2015;125(5):1137-43. doi:10.1002/lary.24956Blackabey V, Gan RWC, Buglass H, Kaul V, Ward VMM.Granulomatosis with polyangiitis causing subglottic stenosis-two cases and their management.AME Case Rep. 2018;2:17. doi:10.21037/acr.2018.03.01D’andrilli A, Venuta F, Rendina EA.Subglottic tracheal stenosis.J Thorac Dis. 2016;8:S140-7. doi:10.3978/j.issn.2072-1439.2016.02.03Yokoi A.Congenital tracheal stenosis: what should we look at for successful tracheoplasty?Transl Pediatr. 2018;7(3):229-232. doi:10.21037/tp.2018.07.01Desuter G, Gregoire A, Gardiner Q, Houssiau F.Hydroxychloroquine as treatment for inflammatory subglottic stenosis: a second successful case.Case Rep Otolaryngol. 2012;2012:754308. doi:10.1155/2012/754308Ezemba N, Echieh CP, Chime EN, et al.Postintubation tracheal stenosis: surgical management.Niger J Clin Pract. 2019;22(1):134-137. doi:10.4103/njcp.njcp_288_18Liu J, Zhang CP, Li Y, Dong S.Post-intubation tracheal stenosis after management of complicated aortic dissection: a case series.J Cardiothorac Surg. 2015;10:148. doi:10.1186/s13019-015-0357-zSongu M, Ozkul Y.Risk factors for adult postintubation tracheal stenosis.J Craniofac Surg. 2019;30(5):e447-e450. doi:Farzanegan R, Farzanegan B, Alehashem M, et al.Item selection and content validity of the risk factors of post-intubation tracheal stenosis observation questionnaire for ICU-admitted patients.Tanaffos. 2017;16(1):22-33.Irwin RS.Evaluation of wheezing illnesses other than asthma in adults. UpToDate.Hofferberth SC, Watters K, Rahbar R, Fynn-thompson F.Management of congenital tracheal stenosis.Pediatrics. 2015;136(3):e660-9. doi:10.1542/peds.2014-3931Hyzy RC.Complications of the endotracheal tube following initial placement: prevention and management in adult intensive care unit patients. UpToDate.Paradis TJ, Dixon J, Tieu BH.The role of bronchoscopy in the diagnosis of airway disease.J Thorac Dis. 2016;8(12):3826-3837. doi:10.21037/jtd.2016.12.68Lee KH, Kang ES, Jung JW, Park JH, Choi YG.Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report.Korean J Anesthesiol. 2013;65(3):254-6. doi:10.4097/kjae.2013.65.3.254Radiopaedia.Tracheal stenosis.Adali F, Uysal A, Bayramoglu S, Guner NT, Yilmaz G, Cimilli T.Virtual and fiber-optic bronchoscopy in patients with indication for tracheobronchial evaluation.Ann Thorac Med. 2010;5(2):104-9. doi:10.4103/1817-1737.62474Votruba J, Zemanová P, Lambert L, Vesela MM.The role of airway and endobronchial ultrasound in perioperative medicine.Biomed Res Int. 2015;2015:754626. doi:10.1155/2015/754626Johns Hopkins Medicine Health Library.Pulmonary function tests.Memorial Sloan Kettering Cancer Center.Treatment of tracheal stenosis.Auchincloss HG, Wright CD.Complications after tracheal resection and reconstruction: prevention and treatment.J Thorac Dis. 2016;8(Suppl 2):S160-7. doi:10.3978/j.issn.2072-1439.2016.01.86
Raman T, Chatterjee K, Alzghoul BN, et al.A bronchoscopic approach to benign subglottic stenosis.SAGE Open Med Case Rep. 2017;5:2050313X17713151. doi:2050313X17713151
Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J.Causes and consequences of adult laryngotracheal stenosis.Laryngoscope. 2015;125(5):1137-43. doi:10.1002/lary.24956
Blackabey V, Gan RWC, Buglass H, Kaul V, Ward VMM.Granulomatosis with polyangiitis causing subglottic stenosis-two cases and their management.AME Case Rep. 2018;2:17. doi:10.21037/acr.2018.03.01
D’andrilli A, Venuta F, Rendina EA.Subglottic tracheal stenosis.J Thorac Dis. 2016;8:S140-7. doi:10.3978/j.issn.2072-1439.2016.02.03
Yokoi A.Congenital tracheal stenosis: what should we look at for successful tracheoplasty?Transl Pediatr. 2018;7(3):229-232. doi:10.21037/tp.2018.07.01
Desuter G, Gregoire A, Gardiner Q, Houssiau F.Hydroxychloroquine as treatment for inflammatory subglottic stenosis: a second successful case.Case Rep Otolaryngol. 2012;2012:754308. doi:10.1155/2012/754308
Ezemba N, Echieh CP, Chime EN, et al.Postintubation tracheal stenosis: surgical management.Niger J Clin Pract. 2019;22(1):134-137. doi:10.4103/njcp.njcp_288_18
Liu J, Zhang CP, Li Y, Dong S.Post-intubation tracheal stenosis after management of complicated aortic dissection: a case series.J Cardiothorac Surg. 2015;10:148. doi:10.1186/s13019-015-0357-z
Songu M, Ozkul Y.Risk factors for adult postintubation tracheal stenosis.J Craniofac Surg. 2019;30(5):e447-e450. doi:
Farzanegan R, Farzanegan B, Alehashem M, et al.Item selection and content validity of the risk factors of post-intubation tracheal stenosis observation questionnaire for ICU-admitted patients.Tanaffos. 2017;16(1):22-33.
Irwin RS.Evaluation of wheezing illnesses other than asthma in adults. UpToDate.
Hofferberth SC, Watters K, Rahbar R, Fynn-thompson F.Management of congenital tracheal stenosis.Pediatrics. 2015;136(3):e660-9. doi:10.1542/peds.2014-3931
Hyzy RC.Complications of the endotracheal tube following initial placement: prevention and management in adult intensive care unit patients. UpToDate.
Paradis TJ, Dixon J, Tieu BH.The role of bronchoscopy in the diagnosis of airway disease.J Thorac Dis. 2016;8(12):3826-3837. doi:10.21037/jtd.2016.12.68
Lee KH, Kang ES, Jung JW, Park JH, Choi YG.Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report.Korean J Anesthesiol. 2013;65(3):254-6. doi:10.4097/kjae.2013.65.3.254
Radiopaedia.Tracheal stenosis.
Adali F, Uysal A, Bayramoglu S, Guner NT, Yilmaz G, Cimilli T.Virtual and fiber-optic bronchoscopy in patients with indication for tracheobronchial evaluation.Ann Thorac Med. 2010;5(2):104-9. doi:10.4103/1817-1737.62474
Votruba J, Zemanová P, Lambert L, Vesela MM.The role of airway and endobronchial ultrasound in perioperative medicine.Biomed Res Int. 2015;2015:754626. doi:10.1155/2015/754626
Johns Hopkins Medicine Health Library.Pulmonary function tests.
Memorial Sloan Kettering Cancer Center.Treatment of tracheal stenosis.
Auchincloss HG, Wright CD.Complications after tracheal resection and reconstruction: prevention and treatment.J Thorac Dis. 2016;8(Suppl 2):S160-7. doi:10.3978/j.issn.2072-1439.2016.01.86
Axtel, AL & Mathisen, DJ. Current Surgical Therapy: The Management of Tracheal Stenosis. 882-887.Patel, HH, Goldenberg, D & McGinn, JD. Cummings Otolaryngology: Surgical Management of Upper Airway Stenosis. 2015;68:982-992.e2.Waizel-Haiat, S. Tracheal Stenosis Imaging.http://emedicine.medscape.com/article/362175-overview
Axtel, AL & Mathisen, DJ. Current Surgical Therapy: The Management of Tracheal Stenosis. 882-887.
Patel, HH, Goldenberg, D & McGinn, JD. Cummings Otolaryngology: Surgical Management of Upper Airway Stenosis. 2015;68:982-992.e2.
Waizel-Haiat, S. Tracheal Stenosis Imaging.http://emedicine.medscape.com/article/362175-overview
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