What is tracheal stenosis and how to treat it?
With the defeat of tracheal stenosis is given special attention. Airway obstruction often develops in adults and children, causing failure of this hollow tube. Common tracheal stenosis is a symptom complex, which is expressed in a complete or partial pathological narrowing of the lumen of the tubular body.
Causes of stenotic lesions of the trachea
The development of the pathology can be caused by various factors:
- If the hot air enters into the respiratory system, there is thermal injury, develop severe tracheal stenosis. This is happening in a burning house in the fire, if not properly treated with the inhalation of hot steam.
- The narrowing of the lumen of a tubular hollow organ from the inside observed in the malignancy.
- The external influence of the tumor process in the unpaired organ.
- Complications after tracheostomy. Any physical impact causes mechanical compression of the breathing tube leads to disruption of the trophic tissue of the larynx. When it is restored, there are scars that narrow the lumen of the trachea. This prevents the normal passage of air and disrupts the breathing process.
Signs of narrowing of the trachea
Symptoms associated with a pathology:
- The main manifestation of narrowing of the cartilaginous lumen of the tubular body are frequent attacks of breathlessness, which is caused by insufficient gas exchange in the lungs. The patient brings suffering asphyxia - a critical condition of the body. It is characterized by impaired cardiac function, changes in breath, as the growing shortage of oxygen in the tissues.
- A result of narrowing of the lumen of the airway occurs dyspnea - shortness of breath, disturbance of the depth and frequency of gas exchange, the feeling of lack of air. These feelings are enhanced during exercise, breathing becomes shallow.
- When the expanded clinical changed both phases of the process of absorption of oxygen. There is a stridor - noisy breathing with a sharp wheeze on inhale and exhale. Paroxysmal non-productive cough exacerbates the condition.
- Poor circulation causes cyanosis, characterized by bluish coloration of the skin, mucous membranes.
Abnormal narrowing of the cartilage of the tubular body are developing rapidly. Develops a difficult situation with a poor prognosis.
Classification of stenosis
Classification according to the differentfeatures:
- Malformations of the fetus result in congenital stenosis, stunted physical development. Boys are affected more often.
- The changes in the structure of the trachea as a result of internal disorders play a decisive role. Burns cartilaginous tubular body of various etiologies, the effects of artificial lung ventilation, intubation become a primary cause of stenosis.
- Secondary stenosis is a result of compression of the trachea from the outside of the patients with retrosternal goiter, lymphadenitis, malignant thyroid tumor, Hodgkin's disease and other diseases. Tissue of the affected organs compress the trachea and cause a circular stricture, it becomes slit-like.
- The cause of idiopathic tracheal stenosis cannot be determined. Most often it affects middle-aged women.
- When cicatricial stenosis of the azygos organ as a result of pronounced tuberculosis the rough scar tissue replaces the normal cover of the walls of the respiratory organ.
- The clinical picture of expiratory stenosis of the trachea observed the overflow of air in lung tissue, a rattling cough, expiratory dyspnea without changing the voice.
The degree of narrowing of the respiratory on the following types:
- Stenosis in the stage of compensation with loss of respiratory pauses and minimal manifestations of the disease.
- Subcompencirovanna stenotic disorders during exercise with abnormal inspiratory wheezing for breath.
- Disease in the decompensation stage is characterized by the critical condition of the patient, in which he is constantly.
- The final stage of asphyxia. Complicated course of the pathological process is fraught with the termination of life of the patient.
Acute stenosis is very dangerous. In a short time with constriction of the trachea is manifested the characteristic clinical picture. Suddenly a depression of the respiratory center. Characterized by hypoxemia - lack of oxygen in the blood. This leads to pathological changes of blood circulation, blood pressure.
Develops more rapidly than pathology, so it is more dangerous. In case of delay in the provision of quality care possible sharp deterioration of the patient due to a lack of oxygen. Occurs loss of consciousness, risk of death in just a few minutes. Therefore, in this form of pathology requires emergency assistance.
With the gradual long-term development of stenotic disorders occur with chronic form of the disease.
Basic methods of diagnosis
disease" alt="MRI for the diagnosis of disease">Symptoms of the disease are nonspecific, so it is important to differentiate stenotic disorders with the penetration of a foreign body or bronchial asthma.
More research is needed:
- Anomalies of tracheal elements are identified using arteriography.
- X-ray examination is crucial for diagnosis of this disease.
- Bronchoscopic study allows to diagnose the pathology of the cartilage of the tubular body.
- Magnetic resonance or computed tomography gives the opportunity to see the state of the soft tissues surrounding the trachea.
- To assess the degree of damage and the airway allows spirography.
- Using fibrobronchoscopy is determined by the size of the cartilaginous lumen of the tubular body.
- Functional body plethysmography allows to fully explore the respiratory system.
Treatment of tracheal stenosis
A comprehensive approach is necessary. Long-term pathological narrowing of the lumen of the unpaired body is dangerous. It is crucial to restore the patency of a tubular respiratory organ.
Surgery is performed in critical situations:
- To save the patient's life with the purpose of restoration of violated size of the lumen of a tubular hollow organ endovideoscopic apply advanced perspective techniques. Using begerovaya, ultrasonic degradation, elektromaschine, cryoablation, laser photodegradation are complex high-tech operations.
- Surgeons often perform a bronchoscopy. Minimally invasive operative techniques are employed when indicated. They are the most effective and least traumatic for the patient.
- Pathological education repetiruyut partially or completely. The operation of excision of the tumors.
- If for various reasons to perform endoscopic surgery is impossible, stenting is performed - extension of the affected trachea to its normal diameter with the establishment of a special frame. During this minimally invasive procedure through a stretch of a tubular cartilage body of a special endotracheal tube of appropriate diameter, which allows to keep the lumen and enter the necessary medicines.
- In advanced cases, when stenting cannot be performed, it is possible to transplant the trachea, cultured biotechnologists from stem cells of the patient.
The prognosis of the disease
The prognosis depends on the condition of the patient, his age, the factors that led to the development of the disease. In adults the prognosis is morefavorable than patients of children's age.
Pathological narrowing of the lumen of the tubular body cannot be ignored. The patient may need to obtain expert advice and aid in the detection of early symptoms of tracheal stenosis.
High-tech modern ways of getting rid of tracheal stenosis give good treatment results, help to restore the health of the respiratory system.