Tracheal anomalies and reconstruction

Tracheal stenosis is a relatively rare disorder in the pediatric population and is usually congenital rather than acquired. Congenital tracheal stenosis is usually due to complete tracheal rings, with or without associated vascular compression of the airway. The stenosis may be associated with Down syndrome, VACTERL association, or craniosynostosis. If the stenosis is not severe, it may be a late presentation or an incidental finding. Acquired tracheal stenosis is generally traumatic in origin, either the result of direct injury or more commonly the result of trauma from the cuff or tip of an endotracheal tube. Tracheal stenosis may also occur at the site of a tracheotomy. Tracheal stenosis may coexist but should not be confused with tracheomalacia or vascular compression of the airway. The management of these pathologies is different from the management of tracheal stenosis. A rare cause of congenital tracheal stenosis is a tracheal web, which is usually thin and amenable to endoscopic treatment. This chapter will provide an overview of the diagnosis and management of these entities.