Please call 734-936-8051 to schedule an appointment with one of our Otolaryngology providers.

Patients with airway stenosis do not always exhibit symptoms.  However, some symptoms include:

• Difficulties with breathing, such as shortness of breath, wheezing, or stridor (high-pitched breathing on inspiration)
• Changes in the voice, such as hoarseness or a loss of volume or pitch.
• Swallowing problems such as choking or coughing when you eat or drink 
• Non-productive cough

At the Complex Airway Intervention and Reconstruction Program, your evaluation is customized to your condition.  Your evaluation may include:

• A complete history of your breathing problem
• A physical examination of your head, neck and chest
• Evaluation your breathing ability through pulmonary function testing (PFTs)
• Examination of your throat, voice box, and airway through endoscopy in the clinic or operating room

Imaging of your airways via X-rays or computed tomography (CT) scans.  This may include Dynamic 3D Chest CT-scans, a non-invasive procedure performed with the patient inhaling and exhaling to examine how the airways change with breathing.

Your doctor may recommend non-surgical or surgical treatment options depending on your symptoms and other factors.

Non-surgical treatment

For patients with inflammatory stenosis or idiopathic stenosis, we offer:

• In-Office Serial Intralesional Steroid Injections (SILSI, also called Awake Steroid Injections) – While examining your airway with a scope in the office, your physician injects steroid into the area of narrowing to prevent further development of scar.

For shortness of breath in which breathing mechanics contribute to symptoms, we offer:

• Respiratory retraining therapy

Surgery

We offer a complement of modern and established treatments for airway pathology, including:

• Endoscopic dilation: While examining your airway through the mouth while you are asleep, a balloon or dilator is used to widen (stretch) the airway. Often, a steroid is injected into the area, or a medication called mitomycin is applied to prevent the recurrence of the scar.
• Laser treatment: While examining your airway through the mouth while you are asleep, a laser is used to vaporize and cut the scar in your airway to increase the space to breathe through.
• Endoscopic resection and mucosal reconstitution: Also called the Maddern procedure, in this procedure, your surgeon examines your airway through the mouth while you are asleep and uses a laser to strip all the scar from the narrow area. The airway is then relined with a graft of different tissue. A temporary silicone stent is applied while the graft attaches to your airway.
• Tracheobronchial stenting: While examining your airway through the mouth while you are asleep, the area of narrowing is propped open with an expandable stent made of metal or silicone inserted into the airway through a bronchoscope.
• Open airway reconstruction: Via an incision through the neck or chest, the area of scarring or narrowing is cut away (resected), and the two remaining ends of the airway are sewn back together, resulting in an unobstructed airway. This is called either a tracheal resection or cricotracheal resection, depending on the areas that are removed. Laryngotracheal reconstruction is when a cartilage graft is also used to expand your airway.
• Tracheostomy or T-tube: An incision is made from the front of the neck into the airway, and a tube is inserted into the airway to either bypass or expand the area of narrowing and allow normal breathing.