Are you also having difficulty breathing? Is it due to Tracheal Stenosis? Let's find out for sure!

Do you sometimes feel that it is very difficult to breathe when you climb a flight of stairs or walk a little faster? Or do you hear a whistling sound in your throat when you breathe, especially when you inhale and exhale? Maybe your little baby is gasping for breath and looks tired when he/she drinks milk? Don't just ignore these things. Because there may be a medical reason behind them. That is one such condition that we are going to talk about today. That is Tracheal Stenosis .

Simply put, what is Tracheal Stenosis?

Don't be alarmed by this name. Let's understand this very simply. Your windpipe, that is, the part we call the windpipe (in English, `Trachea`), is the part that takes the air we take in from our nose and mouth to our lungs. It's like a pipe that carries water from a water tank. Now think about it, what happens if this pipe becomes narrow or blocked from the inside for some reason? The flow of water decreases, right? That's how it is.

Tracheal Stenosis is when your windpipe becomes narrowed for some reason. This narrowing can be due to an infection, an injury, or the growth of scar tissue. When the windpipe becomes narrowed in this way, there is less room for air to get into the lungs. This is when breathing difficulties occur.

"Stenosis" is a medical term for an abnormal narrowing of a tube or passage in the body. This can occur in various places in the throat.

• Laryngotracheal Stenosis: In this, both the windpipe (trachea) and the voice box (larynx) become narrowed.
• Subglottic Stenosis: This is a narrowing of the area below the vocal cords, but above the windpipe.

There are two main ways this situation can occur.

Tracheal stenosis can be divided into two main types.

1. Acquired Tracheal Stenosis: This is the most common type. It is caused by an illness, injury, or other cause during our lifetime. It can occur in both adults and children.

2. Congenital Tracheal Stenosis (CTS): This is a condition that is present at birth. It is very rare. It affects approximately one in 64,500 babies. However, it is a very dangerous and life-threatening condition for a small baby. Most of the time, this condition is diagnosed at birth or within the first few months of life.

For a newborn babyThis is an emergency. If your baby is struggling to breathe or showing signs of difficulty breathing, take him to a hospital's emergency room (ETU) without delay.

However, both types cause difficulty breathing. It can have a major impact on your quality of life. That's why it's so important to see a doctor if you have even the slightest suspicion that you or your child has this condition.

What are the symptoms of Tracheal Stenosis?

Many of these symptoms are common to both adults and children. Let's take a look at what these symptoms are.

Characteristics specific to children

In addition to the above symptoms, children may show several other specific symptoms.

• Newborn babies: They may have difficulty feeding from breast milk or a bottle. They may also appear unusually tired after feeding.
• Older children: May choke while eating and have difficulty breathing.
• Older children: A blue discoloration of the skin and gums around the nose (`cyanosis`) may be seen. This is due to the blood not getting enough oxygen.

Why does this situation occur? What are the reasons?

The two types we discussed earlier are caused by different factors.

Cause of congenital condition (CTS):

This occurs when the cartilage that makes up the baby's windpipe does not develop properly, causing the baby's windpipe to be narrower than normal at birth.

Causes of the condition during life:

The main and most common cause of this is prolonged intubation. What is intubation? In cases of difficulty breathing, a tube is inserted into the windpipe through the mouth or nose to help the patient breathe. This is a life-saving treatment. However, sometimes, because this tube is inside the windpipe, it can damage the tissues there, causing scarring and narrowing of the windpipe. When this type of tube is used to breathe in children born with immature lungs, this condition is more likely to occur later.

In addition to intubation, several other factors can affect this:

• Autoimmune diseases: Conditions such as Granulomatosis with Polyangiitis (GPA) in which the body's immune system attacks its own cells.
• Inflammatory conditions: Diseases that affect the lungs, such as Pulmonary Sarcoidosis.
• Infections: Bacterial or viral infections that affect the respiratory system, such as tuberculosis.
• Tumors: Tumors are cancerous or noncancerous growths that press on the windpipe.
• Inhalation of toxic substances:Damage to the windpipe from inhaling chemicals or toxic gases.
• Radiation Therapy: As a side effect of radiation therapy directed at the neck or chest.
• Tracheostomy surgery: Scarring after surgery to make a hole in the neck and insert a tube into the windpipe to help with breathing in an emergency.

How does the doctor diagnose this disease?

When you go to a doctor, he or she will listen carefully to your symptoms and, if necessary, refer you for some tests. Ear, nose, and throat (ENT) surgeons are the ones who often treat this condition.

The main tests performed are:

• Endoscopic Procedures: This involves examining the inside of the airway using a thin, flexible tube with a camera attached.
• Bronchoscopy: This is the main test used to diagnose this disease. In this, a tube is passed into the windpipe to see exactly where the narrowing is, its extent, and the cause.
• Laryngoscopy: This examines the vocal cords and the area around them.
• Imaging Procedures:
• CT scan (Computed Tomography scan): A CT scan of the neck and chest can give a good idea of ​​the location and nature of this narrowing.
• MRI Scan (Magnetic Resonance Imaging): Sometimes an MRI scan may be performed to help plan treatment.
• Pulmonary Function Test: This involves asking you to inhale and exhale in different ways to measure how well your lungs are working and how narrowing of your airways is affecting your breathing.

In addition, other tests may be done to find the cause of the disease. For example, a blood test may be done if an infection or inflammation is suspected, or a biopsy (taking a piece of tissue to examine) may be done if there is an unusual lump to determine if it is cancerous.

What are the treatments for this?

The main treatment for this condition is to widen the narrowed windpipe through surgery or other methods. Your doctor will decide the most appropriate treatment for you based on many factors, including the severity of your condition and the location of the narrowing.

There are several treatment options:

• Tracheal Dilation: In this procedure, your doctor inserts a balloon or a special device (a `dilator`) into your windpipe, gradually stretching and widening the narrowed area. This makes it easier to breathe.
• Laser Bronchoscopy: A laser beam is passed through the bronchoscope to burn away the scar tissue that is causing the blockage, thus reopening the airway.
• Trachea Airway Stent: This involves placing a small mesh-like tube (stent) made of plastic or metal inside the blocked airway. The stent helps keep the airway open and free from blockage. However, this is not possible for all patients, and depends on the location of the blockage.
• Tracheal Resection and Reconstruction: This is the most common surgical procedure for this condition. It involves completely cutting out the blocked portion of the windpipe and reconnecting the remaining healthy parts. This can help restore an unobstructed airway.

What can you expect after treatment?

If you have this condition, you may need surgery or another procedure. The recovery time and results for each treatment vary.

For example, a surgery called `Tracheal Resection and Reconstruction` is a bit more serious. But it has a higher chance of resolving the problem of narrowing in the long term. Non-surgical methods like `Tracheal Dilation` are less harmful. You may have to have it done once, or you may have to repeat the procedure from time to time.

How do I take care of myself at home after treatment?

After surgery or another procedure, you will need to follow some special instructions at home. These instructions may vary depending on the treatment you received. Your doctor will explain these to you. They will usually tell you to be careful about things like:

• Food and Drink: For the first 24 hours, you may be asked to limit your intake to liquids or soft foods that are easy to swallow. It is best to eat less spicy foods that are not too spicy.
• Sleeping: For the first few days, you may be asked to sleep with pillows to keep your upper body slightly elevated.
• Pain control: If necessary, you can take over-the-counter pain relievers or medications prescribed by your doctor.
• Activities: You are advised to avoid heavy lifting and strenuous activities for about the first week after surgery.

When should I see the doctor again? What are the times I should go to the ETU?

After treatment, your doctor will give you follow-up appointments to check on your progress. You may be asked to come back every few weeks at first. If you are doing well, you may be asked to come back every few months. You will be monitored until you are completely sure that the condition has not returned.

Call your doctor anytime you feel difficulty breathing . Delaying treatment at a time like this can be dangerous. Therefore, it is essential to seek medical advice.

When should you go to the Emergency Treatment Unit (ETU)?

If you are having trouble breathing, or if the symptoms we discussed earlier reappear, it could be a sign that your Tracheal Stenosis has returned. In such a case, go to an ETU immediately.

Especially, if you are caring for a newborn or young child, if the child shows any difficulty in breathing, immediately take them to the nearest hospital's Emergency Treatment Unit (ETU) without delaying even a minute.