Treatment methods
Common treatment methods
After the diagnosis has been made, usually by a registered ENT doctor or pulmonologist, you should visit a specialized clinic with as much experience as possible. There you will usually first be given a consultation appointment where the stenosis will be examined and various treatment options discussed.
You should always make your treatment appointments in good time; you can often contact the treating clinic doctors directly to do this.
Our members are currently primarily treated with balloon dilation . Cricotracheal resection is only performed very sparingly.
Some are gaining initial experience with outpatient steroid injections or are successfully using inhaled steroids to prolong the intervals between dilations.
High pressure balloon dilation
As a rule, high-pressure balloon dilation is recommended as the first treatment, i.e. stretching the narrow area. The scarred stenosis ring is first incised in a star shape and then expanded with a balloon catheter. In addition, the tissue is injected with a long-acting cortisone preparation.
Dilatation is a gentle procedure that requires a short anesthetic. The risks are minimal, but the constriction usually returns. For most patients, however, dilatation is a long-term solution and can be repeated several times into old age. If dilatation is required every 1-2 years, the dilatation is considered successful. The intervals between dilatations often increase. After dilatation, most of our members describe a significant improvement in their shortness of breath, some even think "why not sooner?" Follow-up appointments should therefore be arranged as early as possible so that the strain does not become too great.
We should not risk an emergency situation, that is what the doctors advise!
Cricotracheal resection
By removing the constriction using a major operation, the CTR, in many cases growth can be stopped or at least paused for many years. However, resection also involves a generally higher risk. Specialists now only recommend cricotracheal resection if dilations are unsuccessful or if there are other reasons not to continue with dilations.
A detailed description can be found at www.klinikum-stuttgart.de
Further treatments:
Outpatient steroid injection
In the USA, and sometimes also in Europe, more and more patients are being treated with steroid injections directly into the neck, which can significantly slow the growth of the stenosis. The distances between the dilatations do increase, but it has been shown that the stenosis does not regress through steroid injections alone.
Laser treatment
The trend to open idiopathic tracheal stenosis using laser incisions is declining, as laser treatments have a high risk of damaging the cricoid cartilage and the structure surrounding the stenosis. The stenosis usually returns. The risk of injury increases with each treatment, which is why it is not suitable for repeated therapy.
An overview of all known treatment methods can be found in Catherine Anderson’s guide.