Tracheal Stenosis

What is tracheal stenosis?

Your trachea (windpipe) moves the air you breathe in through your nose and mouth to your lungs. When you have tracheal stenosis, inflammation or scar tissue in your trachea makes it more difficult for air to get through and for you to breathe.

Who is affected by tracheal stenosis?

There are two types of tracheal stenosis: acquired and congenital:

• Acquired tracheal stenosis is more common and affects children and adults. Acquired tracheal stenosis is caused by illnesses and medical treatments that affect your trachea.
• Congenital tracheal stenosis (CTS) is a serious condition that’s present at birth. CTS is rare; 2 out of 100,000 infants are diagnosed with CST.

Is tracheal stenosis a life-threatening condition?

Tracheal stenosis is life-threatening in infants but not as serious in children and adults. That being said, tracheal stenosis makes it hard to breathe, and that can affect your quality of life or your child’s quality of life.

What’s the difference between tracheal stenosis and subglottic stenosis?

Subglottic stenosis is the narrowing of your airway above your trachea and below your vocal cords.

What are the symptoms of tracheal stenosis?

Many tracheal stenosis symptoms are the same for children and adults. Here are some symptoms children and adults have in common:

• Difficulty breathing after everyday activities like climbing stairs or walking.
• Wheezing.
• Persistent cough.
• Difficulty coughing up mucus.
• Frequent colds, bouts of pneumonia or other respiratory infections.
• Persistent asthma that isn’t better after treatment.
• Chest congestion.
• Pauses in breathing (apnea) and sleep apnea.

Children are more likely to have these symptoms:

• Infants might have difficulty breastfeeding or bottle feeding. They might seem unusually tired after feeding.
• Older children might choke or have difficulty breathing while they eat.
• Older children’s skin around their noses and their gums might appear blue.
• Infants and older children might have noisy breathing.

What causes tracheal stenosis in adults?

Studies show intubation to treat respiratory conditions accounts for more than 60% of tracheal stenosis in adults. Intubation involves inserting a breathing tube into your trachea so you can breathe. You might also develop tracheal stenosis if you:

• Have an autoimmune disorder such as granulomatosis with polyangiitis (GPA).
• Have idiopathic stenosis. This is stenosis with no clear cause.
• Have pulmonary sarcoidosis. This is an inflammatory condition that creates nodules or lumps in your lungs.
• Have an inflammatory or infectious condition such as tuberculosis or other bacterial and viral infections that affect your respiratory system.
• Inhaled a caustic substance.
• Had a tracheostomy.
• Have a benign or malignant tumor pressing on your trachea.

What causes tracheal stenosis in children?

When infants are born prematurely, their lungs are not fully developed. Healthcare providers use breathing tubes to help premature infants breathe while their lungs develop. Premature infants who need to rely on breathing tubes for a long time might develop tracheal stenosis.

What causes tracheal stenosis in infants?

Congenital tracheal stenosis (CTS) is a rare condition that is present at birth.

How do healthcare providers diagnose tracheal stenosis?

Healthcare providers use several tests to diagnose tracheal stenosis and decide how to treat it. Those tests might include:

• Bronchoscopy. Healthcare providers insert a thin, bendable tube into your mouth and down to your trachea while you are sedated so they can see how your trachea functions when you breathe in and out.
• Laryngoscopy. Healthcare providers insert a thin, bendable tube into your nose and down to your trachea in the office without sedation so they can see how your tracheal anatomy appears.
• Computed Tomography (CT) scan.

Pulmonary Function Test. Providers will ask you to complete several tasks, such as walking for 6 minutes, so they can see how your trachea responds when you are active.

How is tracheal stenosis treated?

Tracheal stenosis is usually treated with surgery. Healthcare providers consider several factors before deciding on your treatment options. Those factors include:

• The amount of open space in your trachea’s channel.
• The location of the narrowed area.
• What caused your trachea to become more narrow.

What are common surgical treatments for tracheal stenosis?

Common surgical treatments include:

• Bronchoscopic tracheal dilation. Healthcare providers use a bronchoscope to place a balloon or tracheal dilator in your trachea. The balloon or dilator stretches your trachea so you can breathe. The surgery also helps healthcare providers learn more detailed information about the narrowing in your trachea.
• Laser bronchoscopy. Healthcare providers use a bronchoscope to focus a laser beam on scar tissue in your trachea.
• Trachea airway stent. A stent is a small plastic or metal tube that holds your trachea open.
• Tracheal resection and reconstruction. The area of tracheal scarring and constriction is cut away (resected), and the two remaining ends of your trachea are sewn back together resulting in an unobstructed airway.

Will surgery cure my tracheal stenosis?

Tracheal resection and reconstruction surgeries are more likely to eliminate the narrowing in your trachea. Other treatments such as bronchoscopic tracheal dilation and trachea airway stents are often temporary solutions that sometimes become permanent.

How can I reduce my risk of developing tracheal stenosis?

Unfortunately, the most common cause of tracheal stenosis is intubation, which is a life-saving medical treatment that can’t be anticipated or avoided.

What can I expect if I have tracheal stenosis?

Tracheal stenosis is usually treated with surgery. Each surgery has different recovery times and recommended activities. If you’re having surgery for tracheal stenosis, ask your healthcare provider about post-operative care.

Can tracheal stenosis come back?

Yes, tracheal stenosis can come back, particularly if you have treatment with complications such as an overgrowth of the new tissue and blood vessels that help heal any damage treatment might cause.

Is tracheal stenosis a fatal condition?

Acquired tracheal stenosis, unlike congenital tracheal stenosis, typically isn’t life-threatening. There are several surgical treatments that eliminate or ease tracheal stenosis symptoms.

How do I take care of myself?

You might start by asking your healthcare provider how your surgery will affect you. Every surgery to treat tracheal stenosis will have different post-surgery care. Your healthcare provider will have information about your next steps.

When should I see my healthcare provider?

Your healthcare provider will schedule follow-up appointments to check on your recovery from surgery and to check your trachea.

When should I go to the emergency room?

You should go to the emergency room if you can’t breathe or have other tracheal stenosis symptoms. The symptoms might be a sign your tracheal stenosis has come back.

What questions should I ask my healthcare provider?

Tracheal stenosis is a serious condition that often develops from a medical condition or treatment for a medical condition. If you develop tracheal stenosis, you might want to ask your healthcare provider the following questions:

• Why did I develop tracheal stenosis?
• Is this a serious condition?
• Will I need surgery?
• What are typical side effects of surgery to treat tracheal stenosis?
• Can my tracheal stenosis come back after surgery?

A note from Cleveland Clinic

Intubation — inserting a tube down your throat to help you breathe — is a life-saving treatment. Unfortunately, intubation is the primary cause of tracheal stenosis or the narrowing of your trachea that makes it difficult for you to breathe. (Medical conditions including autoimmune disorders and respiratory infections can also cause your trachea to become narrower.) But you don’t have to live with tracheal stenosis symptoms. Healthcare providers have several treatment options. Talk to your healthcare provider about your options to ease your tracheal stenosis symptoms so you can breathe freely.