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Our otolaryngologists have extensive expertise managing complex adult airway problems. Our team will work with you and physician to ensure you receive the best possible evaluation for your disease.
Because airway disease often affects voice and swallowing function, you will receive a comprehensive voice and swallowing evaluation by our voice and swallow team, which includes speech pathologists and physicians.
Adult airway problems may have one or more causes. These include trauma, inflammatory conditions, infection, autoimmune diseases and reflux disease.
There are a variety of techniques to treat laryngotracheal (airway) problems. Our team’s treatment expertise ranges from endoscopy to open airway surgical techniques.
We work closely with anesthesiologists, intensivists, thoracic surgeons, general surgeons, pulmonologists, speech pathologists and gastroenterologists to provide comprehensive treatment.
Our program was developed by Robin Cotton, MD, professor of pediatrics otolaryngology at UC and physician at Cincinnati Children’s Hospital Medical Center.
Adult Airway Disorders
Tracheal Stenosis
What is Tracheal Stenosis?
Tracheal Stenosis is a condition where the windpipe becomes narrower or is constricted. ‘Trachea’ is another word for windpipe. ‘Stenosis’ means a narrowing of a passage or opening. Our breathing system is called the ‘respiratory system’. When you breathe in through your nose or mouth, air travels down your throat (pharynx) and through the voice box (larynx). Air then travels through the largest airway, the windpipe (trachea). The windpipe has springy hoops of a tissue called cartilage in it, which keeps it open while you breathe. The windpipe branches into two smaller airways called the bronchi, which lead to the two lungs.
The entrance to the voice box (larynx) is covered by a small flap of tissue called the epiglottis, which automatically closes when we swallow to stop food or drink from entering the airways. In the voice box, there are two vocal cords (or vocal folds), with a space between them, which is called the glottis. If you have a sub-glottal stenosis, this means that the narrowing in your windpipe is below the glottis, so it is below your vocal cords. Supra-glottic means above the glottis, so if you have a supraglottic stenosis, it is higher up, above the larynx.
What are the symptoms of tracheal stenosis?
Some people with a tracheal stenosis don’t have any symptoms and other can have one or more of the following symptoms:
• Shortness of breath
• Coughing
• Wheezing
• Difficult or labored breathing (dyspnoea)
• A noise that can hearing when someone is breathing if their windpipe or
voice box has an obstruction in it that is louder and more harsh noise
than a wheeze
• A bluish color in the skin or mucous membranes such as in the mouth or
nose
• Frequent inflammation in the lungs
What causes tracheal stenosis?
There are several different types of tracheal stenosis. These can be divided in to stenoses conditions that are present from birth (congenital), and acquired conditions, which have developed later in life. Conditions where tracheal stenosis can occur include:
• Conditions as a result of treatments
Endotracheal intubation
Tracheostomy
Radiotherapy
Past Surgery
• Congenital Conditions
• External injury
• Cancer
• Autoimmune conditions
Polychodritis
Sarcoidosis
Wegener’s granulomatosis
Idiopathic Subglottic Stenosis
What is Idiopathic Subglottic Stenosis?
Idiopathic means “unknown cause” and Subglottic refers to the part of the airway that is immediately below the vocal cords. Stenosis refers to circumferential narrowing, usually due to scar tissue. Idiopathic subglottic stenosis has become one of the most common indications for tracheal resections and reconstruction.
What are symptoms of Idiopathic Subglottic Stenosis?
The following symptoms are associated with having Idiopathic Subglottic Stenosis:
• Noisy breathing (stridor)
• Recurring croup
• Hoarseness
• Inability to breathe without a tracheostomy tube
What causes Idiopathic Subglottic Stenosis?
There is no known cause identified for this problem, hence, idiopathic. This condition is a very uncommon condition; afflicting women more commonly than men.
Meet the experts of the Adult Airway Reconstruction Program:
Mike Bowen, PA-C
Alessandro de Alaron, MD
Ravi Elluru, MD, PhD
Sid Khosla, MD
Yash J. Patil, MD
Michael Rutter, MD
Keith Wilson, MD
To contact our Adult Airway Division, please call Mike Bowen, PA-C for questions and to refer a patient at:
michael.bowen@healthall.com
(513) 584-0353
Additional Resources:
Tracheotomy Handbook
Tracheal T-tube Handbook
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