Paediatric ImagingTracheal stenosis
narrowing of the tracheal
lumen, that can be
congenital or acquired.
Congenital tracheal and subglottic
stenosis is now less frequently seen than the
stenosis acquired secondary to prolonged endotracheal intubation following prolonged respiratory support in the neonatal period. Plain films or tomograms may be helpful to evaluate the site of narrowing. Most cases, however, require
endoscopy which will also reveal the presence of haemangiomas or other space-occupying lesions.
In congenital tracheal stenosis the trachea is intrinsically narrowed due to the tracheal cartilages being smaller than normal and an absence of the posterior membrane. This results in the trachea being rigid: the term "stove-pipe" trachea is sometimes used. Presentation is usually in the first year of life with respiratory distress, stridor and wheeze. Plain films and endoscopy may be useful to evaluate the condition; however, CT may be more helpful in showing the extent of the lesion and associated vascular anomalies and mediastinal masses. Fluoroscopy is sometimes used to differentiate the rigid narrowing in congenital tracheal stenosis from the variable narrowing in tracheomalacia.
IL