University of Maryland, Baltimore
Some people develop a narrowing of their windpipe (trachea), called benign tracheal stenosis, which can make it hard to breathe. Doctors often treat this by using a bronchoscope-a thin, flexible tube with a camera-to open up the airway or remove scar tissue. While these procedures help patients breathe better, we do not fully understand why the narrowing occurs or how the tissue heals afterward. The purpose of this study is to better understand the biological changes in the airway tissue before and after these standard medical procedures. During the procedure, small samples of tissue that would already be collected as part of normal care will be analyzed in the laboratory. The results may help doctors learn more about airway healing and could guide better treatments in the future.
Benign tracheal stenosis (BTS) is an uncommon but potentially life-threatening condition caused by fibroinflammatory scarring that narrows the airway. Etiologies include post-intubation, tracheostomy, and idiopathic disease. Bronchoscopic intervention is the first-line treatment; however, recurrence rates exceed 50%, and the optimal technique remains uncertain. Two widely used modalities-carbon dioxide (CO₂) laser wedge resection and radial incision with dilation-have never been directly compared in a randomized trial. Preliminary evidence, including our meta-analysis, suggests wedge resection…
Inclusion Criteria: * symptomatic tracheal stenosis * idiopathic subglottic stenosis * iatrogenic tracheal stenosis from intubation or tracheostomy Exclusion Criteria: * positive ANA or ANCA * tracheal stenosis from infection, i.e. TB * tracheal stenosis with cartilage fracture * tracheal stenosis with malacia * tracheal stenosis from malignancy * tracheal stenosis from benign tumor * presence of glottic or supraglottic stenosis
CO2 laser wedge resection - removing scar tissue with laser, leading tissue bridges.
Radial incision with dilation - making radial cuts at the circumferential scar site, followed by balloon dilation.
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