While there are many causes of acquired tracheal stenosis, the most common include neck trauma, burns and prolonged intubation.

Children (and adults) with tracheal stenosis may have the following symptoms:

• Shortness of breath during exercise and sometimes at rest
• Noisy breathing or stridor (can sound like a high-pitched squeal)
• Increased effort to breathe, causing sucking in around the ribs and chest (retractions)
• Cough or chest congestion
• Feeling of phlegm “stuck” in the airway
• Frequent pneumonia or upper respiratory infections
• Asthma that doesn’t respond well to treatment
• Pauses in breathing (apnea)
• Bluish tinge to skin or mucous membrane of the mouth or nose
• Trouble eating
• Breathing that worsens with colds or respiratory illnesses

Your doctor may perform any of the following tests:

• An endoscopy. A flexible fiber-optic scope is passed through the nose to check for any cysts in the larynx.
• A computed tomography (CT) or magnetic resonance imaging (MRI). These tests help define the problem.
• Microlaryngoscopy and bronchoscopy. A test that uses a special telescope to look into the airway. This test is done to confirm the diagnosis and treatment.

In severe cases a tracheotomy may be required. In some children, the tracheotomy may be the cause of the narrowing of the trachea. The voice should be normal unless there is a severe narrowing, or unless there is a second problem affecting the voice.

If there is only mild narrowing of the trachea, with few symptoms, nothing may need to be done. If there are symptoms, or if removal of a tracheotomy is desired, surgery is required. Tracheal stenosis usually affects the upper trachea and may be corrected through a neck incision. Lower tracheal narrowing may need a sternotomy for repair. In some instances stenosis may be fixed endoscopically (through the mouth), sometimes with temporary placement of a stent.

The two most common forms of repair are removal of the narrow area (resection), or increasing the size of the narrow area with cartilage grafts. We have considerable expertise with these techniques in both adults and children.

Call 911 immediately if your child cannot breathe, turns blue, or is unconscious. Call your doctor if your child is having trouble breathing.