Tracheal stenosis

Christine Carqueville

Ellen Benya, M.D.

Children's Memorial Hospital

Abstract

7 month old female with history of stridor

Keywords

Tracheal stenosis, complete tracheal rings, plain film, CT


Publication Date: 2004-12-23

History

7 month old female with history of stridor

Findings

Focal narrowing of the distal intrathoracic trachea seen on plain film and CT. No vascular ring or sling is present.

Diagnosis

Tracheal stenosis secondary to complete tracheal rings.

Differential

Tracheal stenosis secondary to vascular ring/sling, stenosis secondary to intubution - unlikely given length and location.

Discussion

Disproportionate growth of the esophagus in relation to the trachea may result in tracheal stenosis or tracheal agenesis. Tracheal stenosis is the narrowing of the lumen of the trachea, most often due to complete tracheal rings of cartilage. About 90% of tracheal stenosis cases present within the first year of life, but it is a relatively rare disorder. Patients present with wheezing, repiratory distress, or expiratory stridor. One third of reported cases show association with the sling left pulmonary artery complex (SLPA). Congenital tracheal stenosis is rarely seen without another anomaly, with other associated problems including midsegment stenosis or tracheal cartilaginous sleeve.

Plain film x-ray of the chest and airway is the first modality used to identify congenital tracheal stenosis. Both CT and MRI are also useful for evaluating cross-sectional airway narrowing and can help assess associated anomalies. There are 4 different types of tracheal stenosis, including the focal or segmental type (50%), diffuse generalized hypoplasia (30%), focal tracheal stenosis in the subglottic, central, or carinal region, and the carrot or funnel type (20%).

References

  1. Kuhn, J.P., Slovis, T.L., Haller, J.O., CAFFEY'S PEDIATRIC DIAGNOSTIC IMAGING, Elsevier, Inc., 2004, 937-939.

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