Health Library

Tracheal Stenosis

The trachea (windpipe) is the part of the airway between the voice box and the lungs and is made up of “C”-shaped cartilage called tracheal rings. Tracheal stenosis is the narrowing of the trachea that gets in the way of normal breathing. Symptoms can be mild to severe, but are treatable.

There are two types of tracheal stenosis:

• Present since birth (congenital), which is rare
• Caused by an injury or illness (acquired)

What are the Causes of Tracheal Stenosis?

Congenital Tracheal Stenosis: The most common cause of congenital tracheal stenosis is complete tracheal rings.

Acquired Tracheal Stenosis: In most cases, tracheal stenosis develops after birth. Some possible causes include having:

• A breathing tube for a long period of time
• Neck injury
• Mass in the windpipe
• Infection
• Swelling

Signs and Symptoms

Children with tracheal stenosis may have the following symptoms:

• Shortness of breath during exercise and sometimes at rest
• Noisy breathing or stridor (sounds like a high-pitched squeal)
• Increased effort to breathe, causing sucking in around the ribs and chest (retractions)
• Cough or chest congestion
• Feeling of mucous “stuck” in the airway
• Frequent pneumonia or upper respiratory infections
• Asthma that doesn’t get better with common treatment
• Pauses in breathing (apnea)
• Skin around the mouth / nose or gums looks blue
• Choking or difficulty breathing when eating
• Tires easily with eating

Diagnosis

The trachea is hard to see and examine in a regular clinic. In order to diagnose tracheal stenosis, the following tests may be used:

• Microlaryngoscopy and Bronchoscopy: Your child goes to sleep in the operating room for this procedure. A small telescope is used to look in the upper and lower airway for signs of narrowing.
• CT scan: Doctors may need to get a picture of the inside of the chest to see if the airway is abnormal.

Treatment

Treatment depends on the severity of your child’s symptoms.

Mild Symptoms

If symptoms are mild, your child may simply need to see the doctor on a regular basis.

Moderate to Severe Symptoms

For moderate or severe symptoms, your child may need surgery to make the airway larger. This will help your child breathe more easily.

In some cases, your doctor may want to do a surgical procedure called a tracheotomy. In this procedure, an opening is made below the level of airway narrowing. This makes it easier for your child to breathe.

Other possible surgical treatments include:

• Endoscopic surgery, including balloon dilation of the airway.

• Cricotracheal resection, which is a surgery to remove the narrow portion of the trachea and reattach the healthy ends of the trachea. This surgery may be done in a single stage or multiple steps.

• Slide tracheoplasty, which is a surgery where the trachea is opened in front and back. It is then slid up on itself and reconnected. This makes the trachea shorter, but much wider.

When to Call Your Doctor:

Call your child's doctor if your child has:

• Unusual shortness of breath during exercise or at rest
• Frequent chest infections
• Noisy breathing