Diagnosis and symptoms

The diagnosis is made by an ENT physician. If tracheal stenosis is suspected, a CT scan of the larynx and trachea is taken. Furthermore, an ultrasound can also be performed.

In order to get an exact insight into the inside of the trachea, a mirror image of the trachea is recommended. This is done either under local or general anesthesia. Depending on the location of the narrowing, a surgeon and a lung specialist (pneumologist) can be consulted for a more precise diagnosis and planning of the treatment.

Depending on the severity of the tracheal narrowing, the symptoms only begin when the patient is under stress or at rest. If the narrowing leads to a reduction of about three-quarters, then the affected person will have difficulty breathing in stressful situations. However, if the narrowing of the trachea leads to a reduction in diameter of more than three-quarters, then the affected persons often have difficulty breathing at rest.

If the constriction is very severe, there are noises when breathing in. This is called inspiratory stridor. The noise, which sounds like a humming, is caused by the fact that the air at the narrowing in the trachea cannot flow freely, but instead there is turbulence.

Surgery and prophylaxis

It is not possible to treat tracheal stenosis prophylactically. However, patients with chronic complaints in the throat and neck area should consult a doctor at regular intervals in order to rule out a possible inflammatory process and if detected in time. The operation of a tracheal stenosis is a procedure that should be performed by well-trained doctors with several years of experience.

In the course of the operation a stay of 1-2 weeks is necessary. At the beginning, the patient is treated with inhalation sprays for several days. These sprays contain drugs and substances (including cortisone) to support the decongestants of the tissue in the surgical area.

In some cases, prophylactic antibiotics are administered additionally to combat possible pathogens causing infections in the respiratory tract. During the operation itself, the patient is put under anesthesia. This anesthesia is maintained after the end of the operation and the patient is not awakened until the next day.

The purpose behind this is to protect the fresh surgical wounds.The trachea is exposed by a horizontal incision (from left to right or vice versa) on the neck above the sternum. The neck muscles (including the hyoid muscles) and the thyroid gland are pushed to the side by the surgeon. The trachea is then freely prepared from all sides at the height of the constriction and detached from the esophagus behind it.

The trachea is opened through incisions above and lengthwise on the stenosis. The tissue that has caused the narrowing is now removed. The parts of the trachea that were above and below the stenosis are no longer connected.

Only the breathing tube now allows the air to be transported into the lungs. The two ends of the trachea are now pulled together again and sutured. Finally, water is filled into the exposed space around the trachea and air is pumped.

If no air escapes at the seam, the seam is tight. Then the water can be pumped out, the muscles are pushed back and the neck is closed again. Since it can always come to post-bleeding, drains (small plastic tubes) are placed in the wound to drain off any blood that may have collected there.

After the operation, a scar remains on the neck, which is not necessarily visible. Within the first few days, pain may occur in the area of the surgical site. In the long term, however, no permanent complaints should remain. In most cases, antibiotics and decongestant medication are prescribed for the first few days after the operation to support the healing process as much as possible. The patient can be on sick leave for up to a quarter of a year and should take it easy.