Bronchial Stenosis
A narrowing of an airway that carries air into the lung
Quick Facts
- Type: Airway (respiratory) narrowing
- Affected structure: A bronchus leading to the lung
- Common causes: Infection, injury, scarring, tumors
- Key symptoms: Wheezing, breathlessness, recurrent infection
Overview
Bronchial stenosis is an abnormal narrowing of a bronchus, one of the airways that branch from the windpipe (trachea) and carry air into the lungs. When a bronchus becomes narrowed, less air can pass through it, which can cause breathing symptoms and make part of the lung prone to infection or collapse.
The narrowing may affect a large central airway or a smaller branch, and it can be partial or nearly complete. Bronchial stenosis can be present from birth (congenital) or develop later as a result of infection, injury, scarring, or a growth pressing on or blocking the airway. Treatment depends on the cause and severity, ranging from managing the underlying problem to procedures that reopen the airway.
Symptoms
Symptoms depend on which airway is narrowed and how severe the narrowing is. Some mild cases cause few symptoms, while more significant narrowing leads to:
- Wheezing or a whistling sound when breathing, often localized to one area
- Shortness of breath, especially with activity
- A persistent cough
- Recurrent chest infections in the same part of the lung
- Coughing up sputum, and sometimes blood
- Chest discomfort
Because the narrowing affects a specific airway, infections and symptoms may keep returning in the same region of the lung.
Causes
Bronchial stenosis can result from many processes that scar, compress, or block an airway:
- Infections: Severe or chronic infections, including tuberculosis, can scar and narrow a bronchus.
- Injury or instrumentation: Trauma to the chest, prolonged breathing tubes, or procedures can cause scarring.
- Inflammatory conditions: Diseases that cause airway inflammation may lead to narrowing.
- Tumors: Growths inside or pressing on the airway can narrow it.
- Congenital narrowing: Some people are born with a narrowed bronchus.
Finding the cause is an important part of choosing treatment.
Risk Factors
- Previous severe lung infection, including tuberculosis
- Prolonged use of a breathing tube or tracheostomy
- Chest injury or airway surgery
- Lung tumors or masses
- Inflammatory diseases affecting the airways
- A lung transplant, where narrowing can develop at the join
Diagnosis
Diagnosis combines imaging with direct visualization of the airway.
- CT scan of the chest: Shows the airways in detail and can reveal the site and degree of narrowing and any mass.
- Bronchoscopy: A thin camera passed into the airways lets a specialist see the narrowing directly, judge its severity, and take samples if needed.
- Breathing tests: Lung function testing can show the effect of the narrowing on airflow.
- Chest X-ray: May show signs such as a collapsed or repeatedly infected area of lung.
Treatment
Treatment is tailored to the cause, location, and severity of the narrowing.
- Treating the cause: Managing infection, inflammation, or a tumor that is producing the narrowing.
- Bronchoscopic procedures: Specialists can widen a narrowed airway using techniques such as balloon dilation, or place a small tube called a stent to hold the airway open.
- Surgery: In selected cases, the narrowed segment may be removed or reconstructed.
- Supportive care: Treating chest infections, clearing secretions, and supporting breathing as needed.
A respiratory or thoracic specialist guides the choice of treatment, which sometimes needs to be repeated if narrowing recurs.
Prevention
- Seek prompt, complete treatment of serious chest infections such as tuberculosis
- Attend follow-up after airway procedures or prolonged ventilation
- Avoid smoking, which harms the airways and lung tissue
- Report recurrent infections in the same part of the lung for evaluation
When to See a Doctor
See a healthcare provider for persistent wheezing localized to one area, shortness of breath, a cough that will not clear, or chest infections that keep returning in the same place. Seek emergency care for severe or rapidly worsening breathlessness, noisy breathing at rest, a bluish tinge to the lips or face, or coughing up significant amounts of blood, as these can signal a serious airway problem that needs urgent attention.
Frequently Asked Questions
What is bronchial stenosis?
Bronchial stenosis is a narrowing of a bronchus, one of the airways carrying air into the lungs. The narrowing reduces airflow and can cause wheezing, breathlessness, and repeated infections in the affected part of the lung.
What causes a bronchus to narrow?
Common causes include scarring from severe infections such as tuberculosis, injury or prolonged breathing tubes, inflammatory diseases, and tumors inside or pressing on the airway. Some people are born with a narrowed bronchus.
How is bronchial stenosis treated?
Treatment depends on the cause and severity. Options include treating the underlying problem, widening the airway with balloon dilation or a stent during bronchoscopy, and, in selected cases, surgery. Narrowing sometimes recurs and needs repeat treatment.
When is bronchial stenosis an emergency?
Seek emergency care for severe or rapidly worsening breathlessness, noisy breathing at rest, a bluish color of the lips or face, or coughing up significant amounts of blood. These suggest a serious airway problem needing urgent attention.
References
- American Thoracic Society. Airway disorders.
- MedlinePlus, U.S. National Library of Medicine. Bronchial disorders.
- Mayo Clinic. Bronchoscopy.