Narrowing the Pipe: Different Etiologies of Tracheal Stenosis

The trachea serves as the conduit for passage of air between the larynx and the lung bronchi. The tracheal luminal caliber may be narrowed in adults by extrinsic mass effect from adjacent structures; intrinsic stenosis secondary to intubation, inflammatory, systemic, or idiopathic disorders; and benign or malignant masses. Contrast-enhanced CT accurately depicts the source of the stenosis and can measure the length and cross-sectional area of the stenosis and evaluate the extent of locoregional spread with malignancies. In addition, the data are capable of being reformatted by several techniques, including virtual endoscopy and surface-rendered reconstruction. Certain imaging characteristics such as the presence of calcifications and involvement or sparing of the posterior membrane can be useful to suggest a particular diagnosis or differential. Imaging, however, is not usually pathognomonic for a specific benign or malignant tracheal stenotic lesion, and ultimately biopsy is needed to establish a definitive histopathologic diagnosis. Learning Objective: To describe the different etiologies of tracheal stenosis.