What is the trachea?
In humans, the trachea is a cartilaginous tube about 12 cm long and 2-2.5 cm in diameter, extending from the larynx to the bronchi of the lungs, and transports air from the mouth to the lungs. Diseases of the trachea are rare and there are basically 2 types of disease;
Tracheal narrowing
After major accidents or surgeries, patients may be connected to a breathing machine (ventilator) for a long time. In this case, a tube is inserted into the trachea. This tube can cause narrowing of the trachea over time. If the trachea narrows by more than 75 percent, shortness of breath develops and this shortness of breath can be progressive and life-threatening.
How to treat tracheal narrowing?
When narrowing in the trachea is noticed, the initial afford is to locate the location and the size of the narrowing. In this stage tomography of bronchoscopy is used as a diagnostic method. After obtaining the required information, surgical removal of the narrowed part and opening the airway is the best and the most definite treatment.
Tracheal tumor
Another group of diseases that occur in the trachea is tumoral development. Benign or malignant tumoral structures can develop in the trachea. In the presence of such a tumoral formation, which is very rare, regardless of whether it is benign or malignant, the area with the tumoral formation should be removed by surgical treatment without wasting time, taking into account the risk of obstruction of the airway.
You can watch tracheotomy operations in the two videos below.
What are the signs and symptoms of tracheal disease?
-Shortness of breath – Shortness of breath, which can be due to many causes, is also the most important symptom of tracheal diseases. If there is a recent and increasing shortness of breath, it may be a sign of tracheal diseases.
– Wheezing – When there is a disease that narrows the trachea, there may be a wheezing or whistling sound that can be heard from the outside when the patient breathes and this sound increases with effort. This sound produced by the air passing through the narrowed airway occurs in the advanced stage of the disease.
– Stridor – When breathing, the skin in the neck pulls inwards, this is called stridor and is often accompanied by a whistling sound. It occurs during inhalation but not during exhalation. It is a very typical sign of tracheal stenosis.
Blood in sputum – Cancers in the upper parts of the airway, such as lung cancer, may also cause blood in sputum (hemoptysis).
How is tracheal surgery performed?
As a temporary solution for stenosis or obstructing masses in the trachea, the narrow part of the trachea can be partially dilateded by entering the trachea with a thick metal tube through the mouth (bronchoscopy), or if there is a mass, a biopsy can be taken from it or very rarely debridement can be performed to temporarily open the airway obstruction.
Bronchoscopy procedure is performed only to make a diagnosis or to provide temporary relief to save time. For definitive treatment of tracheal stenosis and tumors, tracheal resection (removal of part of the trachea) surgery is required.
Tracheal surgery is a very serious surgery that should only be performed by experienced surgeons in wide, professional centers. This is because the trachea is a very vital organ and there is no artificial prosthesis such as a patch or graft that can be replaced.
Tracheal surgeries are performed through the neck or by opening the rib cage, depending on the affected part of the trachea. The diseased or tumorous part of the trachea is removed and the lower end is sutured to the upper end. Since the trachea is flexible and extensible, up to 4-5 cm of it can be removed without facing any problems. The patient’s head is kept tilted forward for a while after the operation so that the trachea can stretch and lengthen and the suture line is not strained. After a week or two, this restriction is also removed.
Tracheal surgeries are known to have a high chance of success. In some patients, the sutures of the trachea may narrow again in the long term.