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Tracheal stenosis - post-intubation

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

History of previous tracheostomy and recurrent endotracheal intubations. Currently, presented with dyspnea.

Patient Data

Age: 60 years
Gender: Female

Neck

ct

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.

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