Correlation Between Computed Tomography and Endoscopy in the Characterization of Tracheal Stenosis

Accurate preoperative evaluation of tracheal stenosis is essential for guiding treatment decisions. Bronchoscopy is considered the "gold standard," but computed tomography (CT) provides promising results. This study aims to compare the accuracy of CT and bronchoscopy in characterizing tracheal stenosis.

A descriptive and analytical study conducted over 10 years (2013-2023) included 20 patients with tracheal stenosis confirmed by CT and bronchoscopy. The evaluated parameters were the distance from the stenosis to the glottis, subglottic involvement, stenosis length, stenosis grade (Meyer-Cotton classification), and mucosal condition.

The average distance from the stenosis to the glottis was 34 mm in both exams, with significant correlation (r=0.777, p=0.000). The mean stenosis length was 17.6 mm on CT and 15.8 mm on bronchoscopy, also with significant correlation (r=0.689, p=0.001). In two cases, the stenosis was complete and impassable by the bronchoscope. CT accurately predicted the stenosis grade in 70% of cases (r=0.736, p=0.000). Sensitivity for detecting subglottic involvement was 50%, and for granulomas, 25%, with specificities of 94.4% and 93.8%, respectively.

CT correlates well with bronchoscopy in measuring the distance to the glottis, stenosis length, and grade but is less effective for detecting subglottic involvement and granulomatous lesions. Combining both techniques is recommended for optimal pre-treatment evaluation of tracheal stenosis.