Tracheal stenosis: when the canal narrows and prevents good breathing

Tracheal stenosis of inflammatory and traumatic origin is a narrowing of the trachea. The most frequent cause is prolonged intubation and tracheostomy. Less frequent causes are trauma to the neck.

It may also occur in some rare cases in association with other inflammatory diseases.

What factors may contribute to an increased risk of developing tracheal stenosis?

There are two types of factors that can increase the risk of developing stenosis. One group is related to technique, such as:

  • Very prolonged intubations.
  • Tracheostomies in which the healing progresses poorly.

Other factors are related to factors specific to the individual, such as:

  • The presence of infections.
  • Diabetes.

What are the main symptoms of tracheal stenosis?

The earliest symptom is a dry and persistent cough. Subsequently, dyspnea (shortness of breath) and stridor (noise when breathing) appear.

The symptoms are common to other respiratory diseases, which can lead to confusion in the diagnosis.

How should tracheal stenosis be treated and what does its success depend on?

The treatment of choice is surgery, in which the thoracic surgeon will perform surgical resection of the stenotic tracheal fragment and anastomosis (suturing) of the upper and lower fragments to the stenotic area to restore the trachea. The operation is indicated in stenoses that are not very extensive (4-5cm), always assessing the general condition of the patient.

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There are other conservative treatments, such as dilatations with or without placement of an endotracheal prosthesis. However, this type of treatment is much longer and of uncertain outcome.