Hatta Chihiro, Terada Tomonori, Kakibuchi Masao, Ogasawara Hiroshi, Nakasho Keiji, Sakagami Masafumi
Department of Otolaryngology, Hyogo College of Medicine, 1-1 Mukogawa, Hyogo 663-8501, Nishinomiya, Japan.
Auris Nasus Larynx. 2003 Dec;30(4):435-8. doi: 10.1016/s0385-8146(03)00094-4.
Idiopathic tracheal stenosis (ITS) is an extremely rare disease. We report the case of a 32-year-old woman with ITS. She had no history of previous surgery, endotracheal intubation, neck trauma, granulomatous disease, or any other severe respiratory tract infections. She presented with progressive dyspnea on effort and had been treated for bronchial asthma for 3 years. Chest radiography and laboratory examinations revealed no abnormalities. Bronchoscopy demonstrated almost circumferential tracheal stenosis extending for 10 mm from about 20 mm below the vocal cords. Luminal diameter was about 4 mm at the narrowest. Bronchoscopic biopsy revealed increased fibrous tissue and chronic inflammatory cell infiltration (nonspecific inflammatory tissue). These finding are compatible with idiopathic stenosis as reported by Grillo et al. After tracheostomy, the patient was treated by tracheal segmental resection (two rings) with end-to-end anastomosis of the cartilaginous trachea. Symptoms of tracheal stenosis were completely relieved and no recurrence has been observed as of 3 years postoperatively.
特发性气管狭窄（ITS）是一种极其罕见的疾病。我们报告一例32岁患有ITS的女性病例。她既往无手术、气管插管、颈部外伤、肉芽肿性疾病或任何其他严重呼吸道感染史。她因劳力性进行性呼吸困难就诊，曾接受3年的支气管哮喘治疗。胸部X线检查和实验室检查均未发现异常。支气管镜检查显示，从声带下方约20 mm处开始，气管几乎呈环形狭窄，长度达10 mm。最窄处管腔直径约为4 mm。支气管镜活检显示纤维组织增多和慢性炎性细胞浸润（非特异性炎性组织）。这些发现与Grillo等人报道的特发性狭窄相符。气管切开术后，患者接受了气管节段性切除（两个气管环）及软骨气管端端吻合术治疗。气管狭窄症状完全缓解，术后3年未见复发。
