Bronchial Stenosis: Recognizing Symptoms, Causes, and Diagnostic Approaches

Patients with tracheobronchial stenosis may experience a range of symptoms, including persistent coughing, inspiratory wheezing, shortness of breath, and recurrent lung infections distal to the narrowed airway segment. The severity and type of symptoms largely depend on the location of the narrowing, its underlying cause, and the degree of airway obstruction.

Understanding Symptom Progression Based on Narrowing Severity

When airway constriction is less than 50% of the normal diameter, symptoms are often mild and may be limited to a chronic cough. At this stage, noticeable breathing difficulties typically do not occur, or they may only appear during physical exertion. However, as the narrowing progresses beyond 75% of the airway's original width, respiratory distress becomes significantly more pronounced.

Severe Airway Obstruction and Associated Risks

In cases of severe stenosis—especially when it affects major airways—patients can develop critical breathing problems, including audible stridor even at rest. This level of blockage increases the risk of acute respiratory compromise, particularly if mucus production rises, potentially leading to life-threatening airway occlusion or asphyxiation.

Systemic Signs Linked to Underlying Causes

The etiology of bronchial narrowing plays a crucial role in symptom presentation. For instance, stenosis caused by tuberculosis or malignant tumors often comes with systemic manifestations such as unexplained fatigue, loss of appetite, and rapid, unintentional weight loss. These signs suggest a broader pathological process and warrant immediate medical investigation.

Diagnosis: From Imaging to Endoscopic Evaluation

Bronchial stenosis is frequently first detected through a chest CT scan, which provides detailed cross-sectional images of the airways. Once an abnormal narrowing is identified, further evaluation with bronchoscopy is essential. This procedure allows physicians to directly visualize the affected area, assess the extent and nature of the constriction (e.g., inflammatory, fibrotic, or neoplastic), and collect tissue samples if needed.

Accurate diagnosis is key to determining the most effective treatment approach, whether that involves endobronchial interventions, surgical correction, or management of the underlying disease causing the stenosis. Early detection and tailored therapy can significantly improve patient outcomes and quality of life.