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What is tracheal stenosis?

Tracheal stenosis is a constriction or narrowing of the cartilage that supports the windpipe (trachea). It can be present at birth (congenital) or caused by an injury.

This narrowing (stenosis) can be a result of:

  • Complete tracheal rings: One or more rings of the cartilage that supports the trachea appear as O-shaped (instead of C-shaped) and constrict the airway.
  • A tracheal cartilaginous sleeve: The cartilage in trachea forms a sleeve instead of independent rings. This malformation is makes it easy for the airway to become blocked.

What are the symptoms of tracheal stenosis?

Symptoms of tracheal stenosis can be present shortly after birth or develop after an injury to the trachea. Symptoms include:

  • noisy breathing (stridor)
  • recurring pneumonia
  • wheezing
  • blue spells (cyanosis)
  • paused in breathing (apnea)
  • chest congestion

An upper respiratory infection can worsen symptoms.

What causes tracheal stenosis?

Tracheal stenosis can be present at birth (congenital). The cause of congenital tracheal stenosis is unknown.

Tracheal stenosis can also be acquired. It can develop when scar tissue forms in the trachea due to prolonged intubation or airway surgery. Intubation occurs when a tube is inserted into the trachea to help maintain breathing during a medical or surgical procedure. 

How we care for tracheal stenosis

The Center for Airway Disorders at Boston Children’s Hospital provides the most advanced medical and surgical treatments available for airway disorders, including tracheal stenosis. Our team approach includes the expertise of specialists from various fields who provide comprehensive assessment, treatment and follow-up care.

Tracheal Stenosis | Diagnosis & Treatments

How is tracheal stenosis diagnosed?

Tracheal stenosis is diagnosed through a comprehensive aero-digestive evaluation that may include one or more of the following tests:

  • Airway fluoroscopy
  • Bronchoscopy
  • CT with 3‐D reconstruction
  • Echocardiogram
  • Laryngoscopy

What are the treatment options for tracheal stenosis?

Treatment depends on the severity of your child's stenosis. Your child may outgrow the problem without intervention or, if the problem is severe, surgery may be required. Your child’s treatment plan may include:

Endoscopic surgery

Our doctors are experts in the use of minimally invasive techniques to treat tracheal stenosis. In some cases, tissue may be divided using a specialized knife and then dilated with a balloon. Lasers can be used to remove segmental portions of scar tissue.

Open surgery

Our surgeons are also skilled in the use of open surgery to treat tracheal stenosis, performing many of these surgeries annually. The most common surgical procedures to treat this condition are:

  • Laryngotracheoplasty: Surgical repair of the stenosis, during which the narrowed diameter of the windpipe (trachea) is enlarged by inserting an elliptical piece of cartilage (taken from the child’s rib or ear, depending on the size of cartilage needed).
  • Cricotracheal resection: A procedure in which the scar tissue and most of the ring-shaped cartilage of the larynx is cut out and the normal trachea is brought up to replace it. 
  • Segmental tracheal resection: A procedure where surgeons remove the defective tracheal segment and then repair the airway by suturing (attaching) the remaining ends back together.
  • Slide tracheoplasty: A complex procedure to make the airway larger. During this surgery, the narrowed trachea is divided across the middle of the stenosis (the area where the airway is narrowed). A portion of the lower and upper tracheal segments are cut and then attached, resulting in an airway that is wider and shorter than before.

Tracheal Stenosis | Programs & Services