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For tracheal stenoses, surgery with sleeve resection remains the gold standard. Interventional techniques through bronchoscopes including laser or electro resection, balloon dilatation and stent placement provide immediate relief from dyspnea. Stent placement for benign stenoses and malacias should only be considered if all other options are exhausted because side-effects can hardly be avoided. Migration, retained secretions and granulation tissue development are common complications. Newer stents from smarter materials may solve some of the problems. Tracheal obstructions require a multidisciplinary approach. Interventional pulmonologists, ENT-and thoracic surgeons must combine their efforts and techniques for the benefit of the patient.

Tracheal stenosis is a debilitating, potentially life-threatening disorder. It can be grouped into categories according to the underlying disease (malignant or benign), the biomechanical properties (scarring strictures or collapsing malacic segments), the functional behavior (fixed or functional), the degree and extension (narrowing, long, or short), or treatment options (operable or inoperable). For patients, it is usually irrelevant what causes their stenoses. They have the same symptoms: stridor, shortness of breath increasing under exercise, and inability to clear secretions because of an impaired cough function. There is no universal classification. With several leading centers in Europe and the United States, we have proposed a classification system. 1 The chart that has been agreed on has proved helpful for describing and grading most central airway stenoses. This article groups the tracheal stenoses …