[Acquired tracheal stenosis: diagnosis and treatment]

Acquired tracheal stenosis (ATS) is a very unfrequent lesion in the pediatric age group and may be due to diverse causes. Herein, we show our experience in the management of this entity.

We have reviewed the clinical charts of patients diagnosed of ATS in a single institution during the period 1991-2005. The following features have been taken into account: sex, age at diagnosis, ethiology, localization, morphologic type, symptomatology, associated anomalies, type of treatment, complications, results, and time of follow-up.

Ten patients were included in the study, 5 boys and 5 girls. Median age at diagnosis was 6 years (range lmonth-14 years). In five cases, stenosis was due to tracheal intubation, two were postsurgical, one associated to Wegener disease, another caused by a foreign body, and the last was idyopathic. In 6 cases the lesion was located in the cervical trachea, in another two it was originated in the mid-trachea, and in the other 2 in the distal trachea. According to the morphologic type of stenosis, 6 cases were of the inflammatory type, 2 cases were of the diaphragm pattern, and another two were of the "bottle neck" type. Two patients have shown severe respiratory distress and the other 8 showed moderate symptoms. Three cases (30%) had congenital associated anomalies. In 9 patients an endoscopic treatment has been performed and 4 cases were surgically treated. In 3 cases both types of treatment were performed. Results have been satisfactory in 9 cases (90%) and bad in one patient. Mean time of follow-up has been 5,3 years (range 1 year- 10 years).

Although it is a rare lesion, tracheal stenosis should be ruled out in every patient who has been intubated recently and shows stridor or dyspnea. Type of treatment depends on the ethiology and the morphologic characteristics of the stenosis.