Head of Chest Surgery Department of Yeditepe University HospitalsProf. Dr. Sina Ercan stated that the narrowing of the trachea, which is rarely seen in society, can be confused with other diseases...

Yeditepe University Hospital Head of Chest Surgery Department Prof. Dr. Sina Ercan states that very rare tracheal stenosis in the society can be confused with other diseases and adds: "If tracheal stenosis is not detected early, it can lead to both sound loss and death."

• What does tracheal stenosis mean?

The trachea is the name given to the trachea. Tracheal stenosis means stenosis in the weasand. The main airway is single at throat level. It is divided into two parts in the middle of the chest towards the right and left lungs. In the lungs, each branch continues to branch by dividing into two again and again. This creates a very large system that takes oxygen and exhausts carbon dioxide. When there is stenosis in the main airway, it causes shortness of breath as if something big has gotten into the throat. If this disease is not correctly diagnosed and treated, the trachea may become completely obstructed over time and may have to be inserted into the larynx called tracheostomy without treatment in the future. This means that the patient loses his voice and ability to speak.

• What causes tracheal stenosis?

As a result of benign or malignant tumors, thickening of the wall of the airway and narrowing of the airway occurs when it grows into it. If a patient is connected to the respirator at some point in his life, it may cause damage to the wall of the tube trachea placed in that period. Once this damage occurs, even if the patient is removed from the breathing instrument, the hardening continues there, the airway narrows, and the patient has difficulty breathing. These people have serious difficulty breathing unless the stenosis in their trachea is treated. Another critical point is that patients who have been treated for asthma and shortness of breath for years may have this disease in the background. But because it has not been understood for years, they can get the wrong treatment with an asthma diagnosis.

• Is it difficult to diagnose tracheal stenosis?

In fact, we can diagnose this with a very simple method, but it is important to investigate by suspecting that this problem may occur while the patient is being evaluated. Especially if there is such a story in the person's past, then we can observe the diameter of the airway by paying those patients and taking a standard neck and lung film from the side. This test is very simple and inexpensive. If we suspect a narrowing of the trachea in flat films, we'll do a CT scan.

• If tracheal stenosis is detected, what treatment do you apply?

If there is a benign tumor here, we clean it with surgery. We remove the narrow area, release the ends of the airway, and connect it to the end without putting any foreign prostheses or apparatus in between. In this way, the patient regains a normal airway. With advanced technological capabilities and advanced surgical techniques, we can remove 50 percent of the patient's trachea and reassemble the tips without putting anything in between. This means a 5.5-6 cm section in the trachea, which is normally 11-12 cm. We are getting extremely good results. The most important feature that separates the trachea from the esophagus and other tubular organs is that the walls of the trachea do not collapse and remain open for air flow.  The esophagus collapses, you eat the food, it passes and then collapses again. However, the trachea should not collapse so that we can breathe. This is achieved thanks to the cartilage rings on the wall of the trachea. Due to these cartilage rings, which are difficult to heal, tracheal surgeries are multi-specific surgeries. It is recommended that these surgeries be performed in centers with the necessary technical infrastructure and experienced surgeons. Because the greatest chance of success can only be achieved in the first surgery. Repeat surgeries become much riskier as the length of the intact trachea in the hand will become shorter with each surgery.