Tracheal Stenosis


1) Following Trauma to Trachea (see above)
2) Post-XRT or Brachytherapy:
3) Post-Laser Bronch:
4) Congenital Tracheal Stenosis: usually presents soon after birth with circumferential O-rings of cartilage over long portions of trachea
5) Post-Infectious Tracheal Stenosis (see also infection above): Histoplasmosis/ TB/ Mucor/ Aspergillus/ Diphtheria/ Scleroma
6) Mucopolysaccharidoses: Hunter’s syndrome/ Hurler’s syndrome
7) IBD: subglottic stenosis is associated with UC
8) Idiopathic Tracheal Stenosis: predominantly females with short 2-3 cm circumferential tracheal stenosis (made of dense collagen)

1) Post-intubation tracheal stenosis:
a) Cuff tracheal stenosis (circumferential stenosis at site of ETT or tracheostomy tube cuff): most common type
b) Stomal tracheal stenosis (at site of former tracheostomy stoma):





Post-intubation tracheal stenosis (usually allow primary resection):

Idiopatic Tracheal Stenosis (usually allow primary resection):
-Urgent: rigid dilatation recommended until tracheal resection can be done
-Non-urgent: primary tracheal resection (trach and other manipulations should be avoided pre-op as they may compromise future ability to resect)
-Subglottic/high-tracheal lesions: less easily resected/ stenting (with or without laser) may be an option (need to be sutured in place)

Long or complex lesions: T-tube may be useful Congenital tracheal stenosis: surgical resection often difficult, tracheoplasty is probably preferred (widens trachea, shortens length of stenosis)