Editing Tracheal stenosis (section)

== Indications for tracheal resection ==

* Post-intubation or post-tracheostomy stenosis
** Prolonged cuff pressure causes full-thickness necrosis of the tracheal cartilage, causing symptoms from circumferential scar contracture 3-6 weeks after extubation
** Stomal stenosis from tracheostomy occurs with scarring at the anterior tracheal defect (anterior narrowing with normal posterior membranous wall)
** Post-intubation stenosis is amenable to dilation, whereas post-tracheostomy is not
* Trauma
* Inflammatory
** Tracheal infections
** Collagen vascular diseases
* Idiopathic tracheal stenosis
** Occurs most commonly in 20-50yo women, focused at the level of the cricoid cartilage with varying degrees of subglottic involvement
* Primary tracheal tumours
** Consider these for resection if they can be removed with less than half of the longitudinal length of the trachea, and do not have unresectable local extension
** SCC
** Adenoid cystic carcinoma
** Carcinoid
** Mucoepidermoid
* Local tumours with airway invasion
** Almost never an indication for tracheal resection, but locally advanced thyroid cancer may be considered, even in the presence of metastatic disease (because prognosis is still pretty good)