Post-intubation Tracheal Stenosis

post-intubation tracheal stenosis
This road traffic accident victim was intubated (endotracheal tube) for 2 weeks. He developed dyspnea and stridor following extubation. CT scan shows upper tracheal stenosis. Axial images show circumferential irregular granulation tissue internal to normal appearing tracheal ring. 3D external rendering shows location and length of the stenosis. 3D internal rendering “virtual endoscopy” shows the upper orifice of the stenosis (long arrow) distal to vocal cords (short arrows).

Post-intubation stenosis may be acute or chronic:
Acute: results from edema of the tracheal wall or intraluminal granulation tissue (as in present case). Dynamic imaging shows little change in tracheal dimensions.

Chronic: results from fibrosis with deformity of tracheal cartilage. CT scan shows deformity of the tracheal cartilage or posterior tracheal membrane with absent or mild thickening of mucosa & submucosa. Dynamic imaging may show tracheomalacia.

Reference: Webb R and Higgins B: Thoracic imaging: The trachea. Lippincott Williams & Wilkins 2005.

Credit: Dr Ahmed Haroun