Trachea and Left Bronchus Stenosis
by Susanne Shamsolkottabi, Janice Cook-Granroth, Geoffrey McLennan, M.D. and Scott Graham, M.D.
Patient History
A professor presented with increasing breathlessness and difficulty with
speaking during lectures. He had had Wegener's Granulomatosis for
several years and was on maintenance routine steroids. On examination
he had a significant stridor. Examination of the upper airway, gently
performed through the vocal cords, demonstrated a severe subglottic
stenosis. The airway was critically narrowed. The patient was managed
with an awake tracheostomy. Examination of the 3D images
demonstrated that there was enough room below the tracheal stenosis to
insert a tracheostomy tube. CO2 laser was then used to correct the
tracheal stenosis, followed subsequently by balloon bronchoplasty of the
left main bronchus.
MPEG Movies
- The original trans axial section Electron Beam CT data set of tracheal stenosis. The images are 3 mm thick.
-
Bronchoscopy
provide by Angie Delsing:
- Views from July 29, 1997
- View 1
- View 2
- View 3
- View 4
Cross-sectional Area
- At the stenosis, just distal of the vocal cords, the trachea
measures 7 mm2 in area. The anterior-posterior and the
lateral lengths at this point are approximately 2.0 mm and 2.7 mm
respectively.
- At the narrowest point of the left main bronchus, the area of the
stenosis measures 14 mm2. The anterior-posterior and
the lateral lengths at this point are approximately 4.1 mm and 3.4
mm respectively.
- In contrast, the narrowest point of the right main bronchus
measures 94.8 mm2 in area. The anterior-posterior and
the lateral lengths at this point are approximately 10.9 mm and
12.3 mm respectively.
Summary
The CT scan reconstruction showed a segment of severe subglottic
stenosis, and in addition, a significant stenosis of the left main bronchus.
The 3D images allowed for a tracheostomy to be inserted prior to CO2
laser of the tracheal lesion.
©1994-99 Division of Physiologic Imaging, Dept.
of Radiology, Univ. of Iowa
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Last modified: Mon Aug 7 12:15:53 CDT 2000
