Presentation
History of previous tracheostomy and recurrent endotracheal intubations. Currently, presented with dyspnea.
Patient Data
Status post total thyroidectomy. No residual or recurrent lesions.
Segmental decreased transverse diameter of the trachea – cervical segment (subglottic stenosis), (0.5 cm compared to 1.5 cm at the base of the neck) representing 30% stenosis. Stenotic segment length = 3 cm (opposite the closed tracheostomy opening).
Case Discussion
Imaging features are consistent with chronic subglottic tracheal stenosis, at the level of tracheostomy opening, consistent with post-intubation tracheal stenosis. Stenosis occurs in the transverse dimension that is well-demonstrated in axial and coronal planes in an hourglass fashion, with preserved normal anteroposterior dimension of the trachea at the stenotic segment, seen at the mid-sagittal plane and lateral 3D volume rendering image.
Tracheomalacia is seen as a decrease of the anterior-posterior diameter by > 50%, unlike post-intubation tracheal stenosis which commonly stenosis occurs as a decreased in transverse diameter of the trachea, irregular or concentric stenosis.