What is Tracheal Stenosis? Symptoms, Causes, and Treatment Methods

Tracheal stenosis is the narrowing of the trachea due to conditions such as infections or scarring. This narrowing can cause respiratory problems for the patient. Tracheal stenosis can be congenital in some patients. Surgical interventions are used to help the patient breathe more comfortably and to resolve the problems caused by this condition.

What is Tracheal Stenosis?

Tracheal stenosis can be seen due to congenital or acquired health problems. The windpipe (trachea) is composed of "C"-shaped cartilages. When stenosis occurs, these cartilaginous structures narrow. It usually manifests with symptoms such as difficulty in expectorating phlegm, a persistent cough, and difficulty breathing during simple exercises or normal respiration. Acquired stenosis is more common. It can affect both children and adults. While tracheal stenosis reduces the quality of life in adults and children by negatively affecting breathing, it can be fatal when it occurs in infants.

To diagnose tracheal stenosis, in addition to a verbal examination to listen to the patient's complaints, imaging devices such as CT (computed tomography) can be utilized. Once the diagnosis is confirmed, surgical procedures such as widening the windpipe or removing the damaged area may be performed.

How Does Tracheal Stenosis Occur?

Tracheal stenosis is the narrowing of the trachea due to accidents, infections, and respiratory diseases that affect the windpipe. Some of the conditions that lead to tracheal stenosis are listed below:

A condition known as idiopathic stenosis, which occurs in the windpipe just below the vocal cords without any specific cause, can also manifest as tracheal stenosis over time.

It can occur due to viral or bacterial infections affecting the respiratory system.

A tracheostomy, which is used to create a new airway to ensure the patient can breathe, can cause damage and lead to narrowing.

Tumors and cancer cells in the windpipe can cause narrowing of the trachea.

The windpipe can also be damaged in the presence of diseases such as granulomatosis with polyangiitis (GPA) or pulmonary sarcoidosis, as well as by the inhalation of toxic chemicals.

What Are the Symptoms of Tracheal Stenosis?

Individuals experiencing tracheal stenosis develop symptoms such as impaired breathing. Some of the symptoms of tracheal stenosis are listed as follows:

Difficulty in performing daily activities such as climbing stairs or walking moderate distances

Persistent coughs

Wheezing

Frequent illnesses such as the flu, colds, and respiratory tract infections

Asthma symptoms that do not improve despite treatment

Bluish discoloration of the mouth, nose, skin, and mucous membranes

Interrupted breathing or sleep apnea

Infants with tracheal stenosis may experience problems during breastfeeding or bottle-feeding. Older children may encounter issues such as choking or gagging while eating. In infants and children, wheezing and noisy breathing are observed.

How is Tracheal Stenosis Diagnosed?

In individuals suspected of having tracheal stenosis, a verbal examination is performed first. After listening to the patient's complaints, imaging methods may be used for detailed examination. Some of the methods used for diagnosis are as follows:

Laryngoscopy: It is possible to view abnormal conditions in the respiratory tract with the help of a tube with a camera inserted from the nostril toward the trachea.

Bronchoscopy: After the patient is administered a sedative, the changes occurring in the trachea during breathing are examined with the help of a device inserted through the oral cavity.

Neck and Chest CT: It can be used to visualize problems occurring in the respiratory system and the windpipe. It is also preferred to rule out other suspected respiratory system diseases.

Pulmonary function test: It is performed by monitoring respiration during a short walk.

Biopsy: When a tumor structure is encountered in the respiratory system, taking a sample may be preferred to check whether the cancer is benign or malignant.

How is Tracheal Stenosis Treated?

Tracheal stents and surgical interventions are generally used for the treatment of tracheal stenosis. Variables such as the extent of the narrowing and the underlying cause of the problem are evaluated to decide on the type of treatment. Some of the techniques used for the treatment of tracheal stenosis are as follows:

Bronchoscopic tracheal dilation: This is a procedure in which a balloon or a device called a dilator is used to widen the trachea. By stretching the trachea, breathing is enabled to continue more comfortably.

Laser application: If the cause of the narrowing in the trachea is scar tissue, these scars can be cleared using laser beams.

Use of stents: A tracheal stent creates a space in the windpipe, facilitating breathing. Silicone tracheal stents can be preferred, as well as metal ones. During stenting, tubes placed inside the trachea keep the airway open, providing a long-term effect.

Tracheal reconstruction: The narrowed part of the windpipe is excised and sutured back together. In this way, the trachea is reconstructed using only healthy tissue.

Frequently Asked Questions

Tracheal narrowing can occur due to diseases affecting the respiratory system, chest and neck trauma, and infections. In addition, narrowing of the trachea can occur due to benign or malignant tumors developing in the windpipe or scar tissues. Radiation therapy applied to the neck and chest region and autoimmune diseases can also be factors for narrowing. Tracheal cancer occurs in parts of the respiratory system extending to the larynx and bronchi. Tumor formation in this region is rarely observed and requires the intervention of expert physicians in the field. It manifests with symptoms such as difficulty breathing, wheezing, and coughing. As the cancer progresses, symptoms such as hoarseness and difficulty swallowing may appear. Surgical procedures, bronchoscopy methods, and radiation therapy can be used for treatment. Tracheal breathing is also known as a tracheostomy. It involves opening a new airway by making an incision in the windpipe in a sterile environment. A tracheostomy tube is placed in the hole opened by the surgical procedure to keep it open. This method is preferred when there is a problem in maintaining normal breathing or when there is an obstruction or narrowing in the trachea. When a transition to normal breathing is possible, the tracheostomy is removed to allow the hole to close or it is sutured via a surgical procedure. Permanent use is also possible in some patients. A tracheal stent is a hollow tube placed inside the windpipe. It widens the airway and facilitates breathing. Before the procedure, the patient is administered a sedative to ensure comfort during the process. After an anesthetic is sprayed into the throat, a flexible tube is placed into the windpipe with the help of a device called a bronchoscope. When the device reaches the desired area, it is released from the tip of the bronchoscope. It then expands, widening the airway. Tracheal stent removal is generally not preferred, but it may need to be removed for intervention if problems such as stent migration or bleeding occur. Tracheal spasm refers to uncontrolled contractions occurring in the larynx. It can affect breathing and speaking but usually does not pose a life-threatening risk. The trigger for tracheal spasm is usually unknown. However, problems such as stress and reflux can cause spasms. Stomach acid that rises during acid reflux can come into contact with the windpipe, leading to spasms. For treatment, identifying and treating the underlying problem is generally preferred. For example, if spasms are seen due to asthma, the use of medications and nebulizers that facilitate the patient's breathing may be preferred. Pulmonary stenosis, also known as lung narrowing, is caused by the heart valve not functioning properly. The pulmonary valve allows blood to flow from the lower right part of the heart to the lungs, where it becomes oxygen-rich. When the pulmonary valve does not function fully, the heart is forced to use more power. As a result, the heart muscles work harder and thicken, leading to a narrowing in lung volume. This situation can lead to difficulty in daily life, shortness of breath, and a feeling of tightness in the chest. When such symptoms are experienced, the nearest health institution should be consulted without delay for an examination. Tracheal collapse is a progressive problem that causes coughing. Generally, cough suppressants, antidepressants, steroids, and asthma medications are used. In addition, treatment for the problems causing tracheal collapse is sought. For example, if there is a problem in the trachea due to an infection, antibiotic treatment is started. Widening of the windpipe can also be achieved through methods such as tracheal stenting and reconstruction. Treatment of diseases related to the trachea is generally performed by Ear, Nose, and Throat (ENT) specialists. When the underlying cause of some diseases like tracheal stenosis is cancer or tumors, it is possible for an oncology specialist to be involved in the treatment. If problems arise due to infectious diseases, an opinion can be obtained from the infectious diseases department. Tracheal bronchus is a rare disease where non-functional bronchi originate from the trachea and progress toward the upper lung lobe. This disease is congenital and occurs during the baby's development process. It is thought to be caused by reasons such as bronchi developing in the wrong region during development or moving after formation. It may be linked to birth-related problems such as Down syndrome or pulmonary hypoplasia. Opening the trachea is generally performed to insert a tracheostomy into the windpipe. The procedure begins with a horizontal incision in the neck after the patient is administered a sedative in a sterile environment. Following this, the muscles are separated, and a hole is created in the windpipe. In some cases, a small hole is created near the base of the front of the neck, and a lens is inserted through the mouth. With the help of the lens, the necessary hole for the tracheostomy is opened. The preferred method varies depending on variables such as the patient's general condition and the doctor's manual dexterity.

If you are experiencing symptoms such as shortness of breath, coughing, or wheezing, consult our Chest Diseases specialist without delay.

At Hisar Hospital Intercontinental, our expert doctors offer you a personalized diagnosis and treatment plan for tracheal stenosis and other respiratory tract diseases.

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