17 Tracheal Stenosis

Clinical Presentation

34-year-old man with stridor that developed six months after prolonged tracheostomy

Radiologic Findings

Coned-down PA chest radiograph (Fig. 17.1A) demonstrates symmetric narrowing of the tracheal lumen. Chest CT (lung window) with axial and coronal reformation (Figs. 17.1B, 17.1C) demonstrates tracheal narrowing with a reduced coronal diameter and anterior luminal tapering. Surface rendered 3-D image (Fig. 17.1D) of tracheal and central airways shows a tapered area of stenosis in the upper trachea at the level of previous tracheostomy.

Fig. 17.1

Diagnosis

Tracheal Stenosis; Post-Intubation Injury

Differential Diagnosis

• Benign and Malignant Tracheal Neoplasm

• Wegener Granulomatosis

• Amyloidosis

Discussion

Background

Tracheal stenosis is defined as narrowing of the tracheal lumen by more than 10% of its normal diameter. It is a relatively uncommon condition with a frequently insidious onset. Early signs and symptoms may be disregarded or confused with other disorders.