Stenosis in the airway can be the result of prolonged endotracheal intubation, external trauma such as gunshot wound, crush injury, or tracheotomy, an inflammatory or auto-immune process, surgical resection of part of the airway for tumor, or other causes.
Persons with airway stenosis will note a reduced capacity for exercise. Often the clinician hears noisy breathing on inhalation, especially when the patient is asked to fill the lungs quickly. Esophageal stenosis gives symptoms of difficulty swallowing solids more so than liquids.
Subglottic Stenosis, before and after Dilation
Tracheal Stenosis and Collapse
Tracheal Stenosis, Due to Forme Fruste Wegener’s Granulomatosis
Subglottic / Tracheal Stenosis
Subglottic Stenosis, Due to Wegener’s Granulomatosis
Airway Stenosis Caused By Wegener’s Granulomatosis, Before and After Dilations
Tracheal Stenosis, before and after Tracheal Resection and Primary Reanastomosis
Dilation for Post-Radiation Hypopharyngeal Stenosis
Tracheal Deformity and Stenosis, before and after Repair
Sickle Cell Disease and Laryngeal Stenosis
Subglottic Granulation and Curving Airstream
Office-Based Surgery When General Anesthesia Is too Risky
The Adult Result of Infant Cricoid Split
A Fenestrated Trach Tube Allows Voicing when there Is Stenosis
Stenosis of Larynx and Trachea before and after Cricotracheal Resection and Reanastomosis
Stenosis Before and After Dilation for Forme Fruste Wegener’s
Sometimes “low-tech” Is Best for Stenosis
Who knew…? Many Such Injuries Are Never Found
Stenosis at Two Levels: Supraglottic and Glottic
Progressive Radiation Fibrosis Effects on the Larynx and a Solution to some of it
Tracheal Red Herring; the Real Culprit is Cricopharyngeus Spasm
A Different Approach to Inflammatory Tracheal Stenosis
Motivated Airway Examination Avoids Further Surgery
Glottic Web Management Without A Keel
Nuances of Endotracheal Tube Injury
This woman with high-risk comorbidities of diabetes and obesity, was in ventilated in ICU more than a month for pulmonary complications of Covid-19 infection. She had an orotracheal tube in place for 3.5 weeks, and then a tracheotomy tube was placed. Now at her first visit a year later, she remains tracheotomy-dependent, and is told she has bilateral vocal cord paralysis (disproven in the following photo series).
The plan here is posterior commissuroplasty, followed by placement of a smaller trach tube and a trial of plugging. If plugging is tolerated during the day, she will need a sleep study with it plugged at night, given the tracheomalacia and her obesity.
Breathing Tube Injury, not Vocal Cord Paralysis
Tracheal Stenosis: Before and After
In this video, trachea (windpipe) blockage causes shortness of breath until the narrowed segment is removed. You will see views of the trachea before and after surgical repair.
Using Your EARS to Understand Airway Narrowing
A narrowing anywhere in the breathing “pipe” that leads to the lungs causes shortness of breath, typically with harsh inspiratory noise on exertion. Such a narrowing can follow injury, intubation, cancer treatment, auto-immune disorders, etc.
It is possible to gain an immediate understanding of the magnitude of the airway narrowing within minutes by using a simple test “graded” with one’s ears. The severity of the problem can be understood before any examination or X-ray evaluation. Dr. Bastian explains…
Post-Radiation Hypopharyngeal Stenosis
People with larynx or pharynx (voice box or throat) cancer often undergo radiation therapy as part of their treatment regimen. An uncommon complication is stenosis (narrowing, scarring) of the entrance to the upper esophagus at the junction of the throat and esophagus. This video provides an example of this disorder.