Video
Tracheal stenosis is a narrowing of the windpipe that can occur after radiation therapy, prolonged use of a breathing tube, or other procedures.
(14 seconds)
The trachea, also known as the windpipe, is the airway that leads from the larynx (voice box) to the bronchi, which are airways that lead to the lungs. Tracheal stenosis is a narrowing or constriction of the trachea.
Most cases of tracheal stenosis develop when a person's trachea is injured after prolonged intubation — when a breathing tube is inserted into the trachea to help maintain breathing during a medical procedure — or from a tracheostomy (surgical opening of the trachea).
Tracheal stenosis can also develop from a number of other causes, including external injury to the throat; when a benign or malignant tumor presses on the windpipe; certain autoimmune disorders (polychondritis, sarcoidosis, papillomatosis, amyloidosis and Wegener's granulomatosis); and infections (bacterial and fungal infections as well as tuberculosis). It can also develop as a side effect of radiation therapy when administered to treat a tumor in the head or neck.
Learn more below about the symptoms, diagnosis, and treatment of tracheal stenosis that we offer.
Symptoms
Tracheal stenosis can develop slowly. Early signs and symptoms may be mistaken for a variety of other disorders and may delay treatment. Our physician assistants routinely spend time to obtain a detailed evaluation of the following symptoms on a patient's first visit to Memorial Sloan-Kettering.
Symptoms can include:
- shortness of breath
- coughing
- wheezing
- difficult or labored breathing (dyspnea)
- difficult-to-treat asthma diagnosed in an adult
- stridor, a high-pitched musical sound that can be heard as the breath is drawn in and is caused by a blockage in the throat or voice box (larynx)
- frequent inflammation of the lungs (pneumonitis) or recurrent respiratory infections
- fatigue and general feeling of discomfort (malaise)
- cyanosis, a bluish color in the skin or mucous membranes in the mouth or nose
Diagnosis
Video
In a virtual bronchosopy, special high-resolution CT scans are used to examine the airways noninvasively.
(16 seconds)
If a patient exhibits any of the symptoms listed above, the doctor may conduct an evaluation using a number of standard respiratory questionnaires and other assessment methods.
Following this evaluation and assessment, a number of additional tests may be used to diagnose tracheal stenosis, including:
- x-ray of the chest and windpipe
- CT scan of the neck and chest
- laryngoscopy — an endoscopic examination of the larynx (voice box)
- bronchoscopy — an endoscopic examination of the trachea and bronchi
- biopsy
All of these tests are performed on an outpatient basis at Memorial Sloan-Kettering, the majority of which on the day of the clinic visit.
In addition, our team conducts tests to evaluate respiratory function. These include:
- a test called spirometry that gauges how well air moves out of the lungs and helps determine the location of certain types of blockages
- a six-minute walk to test endurance and oxygen levels in the blood.
Physicians at Memorial Sloan-Kettering have developed a CT-scanning technique that enables three-dimensional visualization of the airway. This has been found to be effective in determining both the underlying cause and extent of the tracheal stenosis.
Treatment
Tracheal stenosis can sometimes develop as a result of an underlying medical condition. In those situations, doctors will focus on the other issue before treating the stenosis.
Surgery
Doctors at Memorial Sloan-Kettering will use one or more surgical techniques to treat tracheal stenosis. Surgical management depends on the exact location and extent of the stenosis.
Below are some of the most common surgical options for tracheal stenosis.
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Tracheal Resection and Reconstruction
During a tracheal resection, the surgeon removes the constricted section of the windpipe and rejoins the ends. This is usually a very successful treatment for stenosis, with excellent long-term results. - Tracheal Laser Surgery
In some cases, doctors can use lasers to remove cut the scar tissue that is causing the stenosis. Laser surgery offers good short-term effects and provides temporary relief, but is not usually a long-term solution. In some situations, laser surgery can actually worsen the stenosis. For those reasons, it is important to consider the underlying disorder before using laser surgery to treat tracheal stenosis.
- Tracheal Dilation
Widening of the trachea — either with a balloon or tracheal dilators — provides temporary relief of symptoms and allows doctors to determine how much of the trachea is affected by the stenosis. During the surgery, doctors can also diagnose the cause of the stenosis if it is not already known.
- Tracheobronchial Airway Stent
A tracheal stent is a metal, silicone, or hybrid-type tube that is placed at the site of the stenosis to help keep the airway open. Stents are used as both short- and long-term treatments for stenosis.
