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Laryngeal Cancer Common Symptoms And Treatment

Q1. I have a pain on the part of my throat that is just above the chest bone. When I press on it a little bit, it causes a good bit of discomfort. Being that I use smokeless tobacco, this is kind of worries me. The question is, should I be worried?

The area of your neck you are referring to contains the following structures: thyroid gland, larynx (voice box) and trachea (windpipe). Any condition that affects these structures can cause pain when you touch the area. For example, an enlargement or inflammation of the thyroid gland can cause pain with pressure. More common conditions, such as acid reflux, can also do this. Acid churning up from the stomach can irritate the back of the larynx, which can then be felt as a throat pain. An infection of the trachea, which could be part of an upper respiratory infection, can also cause pain. Cancers of the larynx can cause pain as well.

If you have other risk factors for cancer and the pain has persisted for more than two to three weeks, a visit to your doctor is warranted. Without a thorough head and neck exam, I’d be taking a shot in the dark as to your diagnosis.

Q2. My husband will need a stoma after his laryngectomy. We’re anxious about the impact that will have on our lives and his ability to enjoy things like going out for dinner, exercise, etc. Is it hard to take care of? Does it limit your life very much?

Laryngectomy is a surgery where the entire voice box (larynx) is removed for advanced cancer. After the reconstruction, the esophagus is still attached to the mouth, so swallowing is unchanged. But the windpipe (trachea) is now brought out through the middle of the neck just above the collar bone and this opening is called a stoma. A very, very rough analogy is a blowhole seen in dolphins. So while you swallow the same, patients with a stoma now breathe directly into the lungs, bypassing the mouth and nose.

Taking care of the stoma is relatively minor after healing is complete. In general, speech, dust, water, and sense of smell are all long-term issues with this surgery.

As you breathe, your nose and mouth warm, humidify and filter the air. So the lack of relative humidity can cause crusting around the opening of the stoma. This needs to be regularly cleaned out. Most patients wear a small ascot that conceals the stoma and filters out dust. Since the stoma is open all the time, in addition to keeping dust and other particulate matter out, showering can require an adjustment in order to keep the water out. Though there are some devices that allow patients to swim and even snorkel, patients with stomas must think twice before boating or other activities where they can fall into the water as this poses a very serious risk.

Your sense of smell and taste are diminished due to the lack of air flowing through your nose and mouth, so smoke detectors and devices that detect natural gas are needed. You will also not be able to blow your nose.

I find most patients adjust very well to life after laryngectomy, especially after speech rehabilitation. Several excellent support groups exist for laryngectomy patients, including WebWhispers and local chapters of the Chatterbox laryngectomy support groups. Several other resources for patients and families are listed in the link below.

Q3. I’ve had mild throat discomfort for several months — not really a sore throat but more like swollen glands. I am a smoker, and my father died a year ago from esophageal cancer. I’m scared that I might have cancer. What symptoms should I look out for? When should I see a doctor?

Some signs of head and neck cancer include persistent cough, difficulty or pain with swallowing, persistent hoarseness or changes in voice, coughing up blood (hemoptysis), ulcers or sores that won’t heal, and lumps in the neck. Additional risk factors include a history of smoking and drinking, and in some cases, a family history of head and neck cancer.

These are some things to look for, but by no means does it mean you have cancer if you have any of these symptoms or findings. As a general rule of thumb, symptoms like those you describe should be addressed with your physician if they have persisted for several months. Since you are a smoker and have a family history, a thorough head and neck examination is in your best interest.

Q4. With cancer of the larynx, what determines whether or not you have to have your voice box removed? Should I start learning sign language?

The treatment for cancer of the larynx can include surgery, radiation, chemotherapy or combinations of all three treatments. Surgery can involve removing a part or all of the voice box (larynx). The amount of surgery needed will depend on the site and stage of the cancer. For example, small cancers of the vocal cords can be treated surgically by removing the vocal cords without removing the entire voice box. Alternatively, radiation therapy can be used to treat these cancers without surgery.

However, advanced cancers of the larynx will often require all three treatment options and can often require the removal of the voice box (an operation called a laryngectomy) followed by postoperative radiation and chemotherapy.

Accurate staging of the cancer will require imaging (CT scan or MRI) and an evaluation of the larynx by the surgeon under general anesthesia. In this way, the size, location and extent of involvement of the voice box can be assessed.

If a laryngectomy is recommended, there are many ways to rehabilitate speech. These include various prostheses that allow the development of an esophageal speech that, with practice, is almost 100 percent intelligible by most people. I would discuss these options with your doctor.

Both the American Cancer Society and National Cancer Institute have excellent information about what to expect after laryngectomy, and there are many local support groups for laryngectomy patients.

Q5. My husband has throat cancer. He’s a nonsmoker. He tested positive for HPV-16. Should I be tested for HPV? Do I need to worry about getting cancer too? Thanks.

Human papilloma virus (HPV) has been linked to cervical cancer and some types of oral cancers. HPV-16 is one of several subtypes of the virus that has a link to oral cancer. But many people harbor HPV in their mouths and not everyone develops oral cancer.

Currently, only about 25 percent to 50 percent of oral cancers are associated with HPV-16, and the risk of having HPV-16 and developing oral cancer is not clear. So it is difficult to make definitive recommendations. If you feel you are at risk, I would start with a thorough head and neck exam by a specialist. Any warts or growths in the mouth should be biopsied. Your doctor may also test for the presence of HPV subtypes.

Beyond that, I would discuss your concerns with your doctor and to come up with a plan for cancer surveillance that you feel comfortable with.

Q6. My doctor said we could try targeted therapy for my throat cancer. I don’t understand what that means. She said it wasn’t the same thing as traditional chemotherapy.

In general, targeted therapy refers to a class of drugs that “target” a specific biologic pathway or a specific chemical, protein or cell important in the growth of cancer cells. One of these, the epidermal growth factor receptor (EGFR) is an important regulator of cancer cell growth and is found on the surface of many head and neck cancer cells. Targeted therapies such as cetuximab (Erbitux) can bind to these receptors and disrupt the cellular pathways that control cell growth.

Other drugs in this class can target molecules associated with EGFR that disrupt the communication between these receptors and the nucleus of the cell.

In simpler terms, if chemotherapyis a “dumb bomb” that kills both normal cells and cancer cells, targeted therapies are “smart bombs” that kill only cancer cells. Currently, targeted therapies for oral, head and neck cancer are used in conjunction with more conventional treatments such as chemotherapy and radiationtherapy and are not approved as stand-alone therapy.

Q7. I was treated for stage II laryngeal cancer nearly six years ago and haven’t had a relapse. Does that mean I’m cured? If not, what are my chances that the cancer will come back?

First of all, congratulations. Living through cancer treatment is truly an accomplishment, and I continue to be amazed at the resilience of my own patients who have persevered and have come out the other side — a little battered, perhaps — but cancer survivors.

For most head and neck cancers, the first 12 months from the time you complete treatment is the most critical time, as most recurrences will occur during this period. Every year after the first year, your chance of recurrence goes down. After five years, many people will consider a patient “cured” because the odds of a recurrence at that point are so low.

Having said all of this, if you have survived an advanced cancer, constant vigilance and follow-up are still warranted. Cancer can be a lifelong health issue for many patients. Depending on the type of cancer, recurrences can occur many years after initial treatment. Careful follow-up helps you and your doctor catch any recurrence early, and early detection is the key to long-term survival. So, keep up with your follow-up. If you are a former smoker, it is never safe to go back to smoking. Eat sensibly and well, and take care of your body with regular exercise. You may have to live with cancer, but you can choose to live well.

Q8. My husband was diagnosed with larynx cancer (stage IV) this spring. He has had two sessions of chemotherapy (carboplatin), both of which have been horrific. He is almost incoherent, and the fatigue is incredible. I don’t know if he can take a third session. If you reduce the amount of chemotherapy to reduce side effects, do you still get the same benefit? Or are you just stuck with a certain amount if you want to get better?

For some advanced laryngeal cancers, induction chemotherapy is used to shrink the tumor volume as to make it more amenable for surgery, or as a pretreatment for definitive chemo-radiation therapy. Due to the higher doses of chemotherapy needed in induction therapy, the side effects can be very pronounced. Unfortunately, these doses are also very important in killing the cancer. So in a very real way, there is a race between how much it takes to kill the cancer and how much your body can tolerate.

If your husband has had two sessions of induction chemotherapy, and he is having significant problems, it may be time to re-evaluate the treatment plan. If there has been a significant response to the chemotherapy, surgery may now be an option. Alternatively, he may now be ready for definitive chemo-radiation. I would discuss these issues with your cancer treatment team.

Q9. My oncologist told me about a new kind of chemotherapy called cetuximab for pharyngeal cancer. She said it has fewer side effects. Can I try it, or is it still considered experimental?

Cetuximab is the generic name for the brand-name medication Erbitux, which is a monoclonal antibody that attaches itself to the epidermal growth factor receptor (EGFR) located on the surface of some cells. This is an important pathway in the growth of some cancer cells, including the most common type of head and neck cancer.

Cetuximab is in a class of drugs best thought of as “targeted therapy.” Unlike more traditional chemotherapies that act broadly on many cell types, drugs like cetuximab target specific molecular pathways involved in cancer cell growth. These targeted therapies represent a potential future direction in the treatment of head and neck cancer and are usually given in conjunction with more traditional therapies such as radiation and chemotherapy. Their efficacy as stand-alone therapy is not proven. Cetuximab is approved by the Food and Drug Administration for use in combination with radiation therapy for the treatment of locally or regionally advanced squamous cell cancer of the head and neck. It is also approved for the treatment of recurrent or metastatic squamous cell cancer of the head and neck that has progressed after chemotherapy with platinum-based drugs.

Cetuximab is given intravenously. Other drugs in this class are available in a pill form, an additional benefit.

Studies have shown that cetuximab has its greatest benefits in cancers expressing high levels of EGFR, and your doctor may recommend that your cancer be tested for EGFR levels. Some side effects of this drug include a very severe skin rash and/or acne, because skin has high levels of EGFR.

Cetuximab has moved from clinical trials into more mainstream treatment plans, and although I would not consider it experimental, it is not a “magic bullet” for cancer either. As always, I would thoroughly discuss the pros and cons of any treatment plan with your doctor before you start.

Learn more in the Everyday Health Oral, Head, and Neck Cancer Center.

Tracheal Disorders – Brigham and Women’s Hospital

The trachea, known as the airway or windpipe, is a tube that starts under the larynx (voice box) and runs behind the breastbone. It then divides into two smaller tubes, (bronchi) which lead to the lungs. When breathing, a normal trachea widens and lengthens with each breath. Inflammation can cause scarring and narrowing of the trachea, while birth defects or injury can cause the trachea to become soft and floppy. Tumors can also cause blockage of the trachea or the main bronchi. All of these conditions can severely affect your breathing.

Board-certified thoracic surgeons and pulmonologists at the Brigham and Women’s Hospital Lung Center provide comprehensive, specialized care for patients experiencing tracheal disorders. Their expertise and collaboration with other specialists throughout BWH provide patients with a highly informed diagnosis and a cohesive treatment plan. Should surgery or a procedure be required, our surgeons and interventional pulmonologists are experts in tracheal resection and reconstruction surgery and collaborate with specialized otolaryngologists to ensure the best outcomes.

What are the types of tracheal disorders?

There are two main types of tracheal disorders:

Tracheal stenosis is a narrowing of the trachea, or “windpipe,” that prevents air from fully reaching the lungs. The effects of this narrowing can range in severity from mild to more severe. In the most severe cases, the patient may be dependent on a tracheotomy tube to breathe.

Tracheomalacia is a condition characterized by cartilage in the walls of the trachea that has broken down, semi-causing weakness or floppiness in the windpipe. The trachea should be rigid for normal breathing. Infants can be born with tracheomalacia, but adults can also acquire it in later life.

Tracheal tumors, while rare, can cause narrowing of the windpipe which prevents air from fully reaching the lungs. They can also cause coughing of blood.

Types of tumors include:

Benign: pleomorphic adenoma, squamous cell papilloma, chondroma, granular cell tumor, glomus tumor, neurofibroma

Malignant: adenoid cystic carcinoma, squamous cell carcinoma, malignant epithelial tumor, carcinoid tumor, mucoepidermoid carcinoma, small cell and non-small cell lung cancer

Other tracheal disorders managed by The Lung Center include tracheo-esophageal fistula, an abnormal connection (fistula) between the esophagus and the trachea, and tracheobronchomalacia, a rare condition that occurs when the airway walls are weak, leading them to narrow or collapse.

What are the causes of tracheal disorders?

Tracheal Stenosis

The most common cause of tracheal stenosis is intubation, when a patient has had a breathing tube inserted into the trachea for surgery or other medical procedures.

Other causes may include:

  • External trauma to the throat or chest
  • Thermal or caustic injuries
  • Chronic inflammatory disease
  • Infections, including tuberculosis
  • Tumors that press against the trachea
  • Radiation therapy
  • Idiopathic (unknown) cause common in young women
  • Pressure from other structures in the chest such as blood vessels
  • Autoimmune disorders, such as: sarcoidosis, Wegener’s granulomatosis and amyloidosis

Tracheomalacia

Tracheomalacia can have many causes, the most common are:

  • Damage from surgery or procedures on the trachea or esophagus
  • Damage from long-term breathing tube or tracheostomy
  • Chronic infections such as bronchitis
  • Polychondritis (inflammation of the cartilage in the trachea)
  • Emphysema
  • Gastroesophageal reflux disease (GERD)
  • Inhaling irritants

What are the symptoms of tracheal disorders?

Tracheal Stenosis

  • Many patients do not experience any symptoms of tracheal stenosis. However, you may exhibit one or more of the following:
  • Wheezing
  • Stridor (a high-pitched, musical breathing sound)
  • Shortness of breath
  • Difficulty breathing/respiratory distress
  • Coughing
  • Hoarseness
  • Frequent upper respiratory infections, such as pneumonia
  • Asthma that resists treatment
  • Bluish color to the skin
  • Bluish color in the mucous membrane of the mouth or nose
  • Hemoptysis or coughing up blood

Tracheomalacia

  • Shortness of breath
  • Chronic cough
  • Hoarseness
  • Recurring respiratory tract infections
  • Abnormal breathing noises that improve when you change your position or are sleeping
  • High-pitched, noisy breathing, sometimes with a rattling sound
  • Difficulty swallowing food

How are tracheal disorders diagnosed?

Tracheal Stenosis

In addition to a careful physical examination, The Lung Center team may perform the following procedures to determine if your symptoms are caused by tracheal stenosis:

  • Pulmonary Function Test measures how well the lungs work.
  • CT scan uses a combination of X-rays and computer technology to produce horizontal, or axial, images of any part of the body, including the bones, muscles, fat and organs.
  • Dynamic 3D chest CT scan takes a closer look at the area of stenosis while the patient inhales and exhales to outline the structures for surgical planning.
  • Chest X-ray uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs on film or digital media.
  • Bronchoscopy uses a bronchoscope to examine the inside of the trachea, bronchi (air passages that lead to the lungs)

Tracheomalacia

After taking your medical history and performing a careful physical examination, The Lung Center team may perform the following procedures to confirm a diagnosis of tracheal stenosis or tracheomalacia:

  • 6-minute walk test measures the distance an individual can walk over a period of 6 minutes on a hard, flat surface to determine functional exercise capacity.
  • Advanced cardiopulmonary exercise testing uses catheters during exercise (treadmill or stationary cycling) to measure heart and lung function.
  • Bronchoscopy uses a bronchoscope to examine the inside of the trachea, bronchi (air passages that lead to the lungs). It allows for precise diagnosis of the problem and measurement of the area affected to determine the best possible therapy options.
  • CT scan uses a combination of X-rays and computer technology to produce horizontal, or axial, images of any part of the body, including the bones, muscles, fat and organs.
  • Chest X-ray uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs on film or digital media. Laryngoscopy allows your doctor to examine the back of your throat, larynx and vocal cords using a scope (laryngoscope).
  • Magnetic resonance imaging (MRI) uses strong magnetic fields, radio waves and field gradients to image the anatomy and physiological processes of the body. This procedure provides a non-invasive method of assessing the trachea.
  • Pulmonary Function Test measures how well the lungs work.
  • Pulmonary ventilation/perfusion scan involves two nuclear scan tests: injection of radioactive albumin into your veins and breathing radioactive gas through a mask to allow a machine to measure circulation (perfusion) and breathing (ventilation).

What are the treatment options for tracheal disorders?

Tracheal Stenosis

There are several surgical options to treat tracheal stenosis. Your thoracic surgeon will recommend the best option for you, based on the cause, location and severity of the narrowing. Possible treatments and procedures are:

  • Argon plasma coagulation (APC) is a form of non-contact electrocoagulation using a flexible bronchoscopy which allows for rapid coagulation with minimal mechanical trauma to the tissue. This procedure is used for patients who are unable to undergo tracheal reconstruction for medical or personal reasons.
  • Bronchial artery embolization (BAE), a procedure involving X-rays to examine the bronchial arteries using a special dye to determine what is causing your haemoptysis so the bleeding can be stopped.
  • Bronchoscopic Tracheal dilation uses a balloon, tracheal dilator or electrocautery to widen the trachea. This procedure provides immediate relief for symptoms as well helps your thoracic surgeon determine the extent of the stenosis.
  • Laser bronchoscopy uses lasers to remove scar tissue and proves excellent short-term relief for symptoms.
  • Tracheobronchial airway stent or T-tube, a non-invasive procedure that uses a bronchoscope to place a stent to keep the airway open.
  • Tracheal resection and reconstruction, where the scarred and constricted section of the trachea is removed and the upper and lower sections are rejoined. This treatment has excellent long-term results and is the first indicated procedure for certain tumors and stenosis.
  • Tracheobronchoplasty, a procedure performed at few hospitals across the United States, that involves suturing mesh to the outside of a patient’s trachea through a series of knots, which opens the collapsed tissue in the tracheal wall to create an opening to process air. The goal is that the area will scar over, thereby strengthening the structure and making it permanent.

Tracheomalacia

Often, tracheomalacia can improve without treatment. However, you should be monitored closely if you suffer from frequent respiratory infections. Treatments may include:

  • Continuous positive airway pressure (CPAP) uses mild pressure to keep the airway open.
  • Chest therapy, including deep breathing exercises and tapping the chest to break up mucus.
  • Speech and language therapy to adjust breathing patterns and swallowing issues.
  • Tracheobronchial airway stent or T-Tube, a non-invasive procedure that uses a bronchoscope to place a stent to keep the airway open.

Surgical Treatment

  • Tracheal resection and reconstruction, a surgical method that removes the constricted section of the trachea and rejoins the upper and lower sections. This treatment often has excellent long-term results.
  • Tracheostomy, a surgical procedure that creates an opening to the trachea through the neck.
  • Tracheoplasty, a surgical method to support the floppy airway and prevent its collapse. This can be achieved with the tightening of the loose trachea and the support of surrounding tissue or plastic mesh.

Tracheal Tumors

In addition to using some of the surgical procedures listed above, your physician may treat your tumor using some of the following therapies:

  • Brachytherapy involves locally-delivered radiation therapy to the airway.
  • Photodynamic therapy (PDT) uses the light of a specific wavelength to kill cells and damage tumor vasculature, with the goal of inducing an inflammatory reaction that helps to eliminate the tumor.

What can I expect?

When you become a patient of The Lung Center you will meet with many members of the team who will carefully review your medical history and conduct a thorough diagnostic evaluation. You will receive a recommendation for a therapy tailored just for you, based on your specific disorder and other factors, as well as comprehensive monitoring.

Team-based care

Patients with tracheal disorders benefit from the wide range of expertise at The Lung Center. Collaboration between thoracic surgeons, pulmonologists, otolaryngologists, radiologists, respiratory and speech therapists and other specialists and other specialists ensures comprehensive evaluation and effective treatment. If your medical team discovers an underlying illness or concern, you will be referred to a BWH physician for an expert evaluation.

Any surgery recommended will be performed by an experienced, board-certified thoracic surgeon, interventional pulmonologist or interventional radiologist who is an expert in tracheal disorders, in collaboration with the treatment team that including nurses and physician assistants who specialize in caring for patients with tracheal disorders. Your surgeon will also collaborate with pulmonologists and otolaryngologists to tailor a treatment plan for you. Our specialized care team has some of the best results in the country.

Where are you located, and how do I book an appointment?

Do you have additional resources on tracheal disorders?

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

Picture, Function, Conditions, and More

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The trachea, commonly known as the windpipe, is a tube about 4 inches long and less than an inch in diameter in most people. The trachea begins just under the larynx (voice box) and runs down behind the breastbone (sternum). The trachea then divides into two smaller tubes called bronchi: one bronchus for each lung.

The trachea is composed of about 20 rings of tough cartilage. The back part of each ring is made of muscle and connective tissue. Moist, smooth tissue called mucosa lines the inside of the trachea. The trachea widens and lengthens slightly with each breath in, returning to its resting size with each breath out.

Trachea Conditions

  • Tracheal stenosis: Inflammation in the trachea can lead to scarring and narrowing of the windpipe. Surgery or endoscopy may be needed to correct the narrowing (stenosis), if severe.
  • Tracheoesophageal fistula: An abnormal channel forms to connect the trachea and the esophagus. Passage of swallowed food from the esophagus into the trachea causes serious lung problems.
  • Tracheal foreign body: An object is inhaled (aspirated) and lodges in the trachea or one of its branches. A procedure called bronchoscopy is usually needed to remove a foreign body from the trachea.
  • Tracheal cancer: Cancer of the trachea is quite rare. Symptoms can include coughing or difficulty breathing.
  • Tracheomalacia: The trachea is soft and floppy rather than rigid, usually due to a birth defect. In adults, tracheomalacia is generally caused by injury or by smoking.
  • Tracheal obstruction: A tumor or other growth can compress and narrow the trachea, causing difficulty breathing. A stent or surgery is needed to open the trachea and improve breathing.

Trachea Tests

  • Flexible bronchoscopy: An endoscope (flexible tube with a lighted camera on its end) is passed through the nose or mouth into the trachea. Using bronchoscopy, a doctor can examine the trachea and its branches.
  • Rigid bronchoscopy: A rigid metal tube is introduced through the mouth into the trachea. Rigid bronchoscopy is often more effective than flexible bronchoscopy, but it requires deep anesthesia.
  • Computed tomography (CT scan): A CT scanner takes a series of X-rays, and a computer creates detailed images of the trachea and nearby structures.
  • Magnetic resonance imaging (MRI scan): An MRI scanner uses radio waves in a magnetic field to create images of the trachea and nearby structures.
  • Chest X-ray: A plain X-ray can tell if the trachea is deviated to either side of the chest. An X-ray might also identify masses or foreign bodies.

Tracheal Stenosis | Cedars-Sinai

Overview

The trachea, commonly called the windpipe, is the airway between the voice box and the lungs. When this airway narrows or constricts, the condition is known as tracheal stenosis, which restricts the ability to breathe normally.

There are two forms of this condition:

  • Acquired – caused by an injury or illness after birth
  • Congenital – present since birth

Most cases of tracheal stenosis develop as a result of prolonged breathing assistance known as intubation or from a surgical tracheostomy.

Symptoms

The symptoms of tracheal stenosis are similar to those of other conditions so it is important to see physician, particularly if the patient has experienced an injury to the throat. In addition to a feeling of fatigue or a general feeling being unwell (malaise), the symptoms of tracheal stenosis typically are:

  • Wheezing, coughing or shortness of breath, including difficulty breathing
  • A high-pitched squeal coming from your lungs when inhaling
  • Frequent bouts of pneumonia or upper respiratory infections
  • Asthma that doesn’t respond well to treatment
  • Chest congestion
  • Pauses in breathing (apnea)
  • A blue color in the skin or mucous membrane of the mouth or nose

Causes and Risk Factors

Though rare, tracheal stenosis may be present at birth. More commonly, the condition is the result of an injury or illness, such as

  • An external injury to the throat or chest
  • Infections of a viral or bacterial nature, including tuberculosis
  • An autoimmune disorder such as sarcoidosis, papillomatosis, Granulomatosis with polyangiitis and amyloidosis
  • Tumors, benign or malignant, which may press against the trachea, thereby restricting air flow
  • Occasionally, tracheal stenosis may develop after radiation therapy to the neck or chest

Diagnosis

Tracheal stenosis typically is suspected in individuals with risk factors presenting with signs and symptoms of airway stenosis (see below). The condition may be further suspected based on spirometry with a flow-volume loop and computed tomography imaging of the neck and chest but fiberoptic bronchoscopy is generally required to confirm the presence and severity of tracheal stenosis.

Treatment

There are several treatment options that can be used for tracheal stenosis and the type of treatment used will depend on the cause, location and severity of the tracheal narrowing. The surgeons at the Women’s Guild Lung Institute use minimally invasive techniques whenever possible, although even those procedures require general anesthesia and a hospital stay. Some treatment options can provide immediate relief but are considered temporary solutions, while others can provide a better long-term solution.

Short-term treatment options for the condition include laser surgery and widening the trachea. Laser surgery can remove scar tissue that is causing tracheal stenosis. This treatment option can provide short-term relief but usually isn’t considered a permanent solution. For some patients, laser surgery can make the condition worse, so it is important for patients to see a knowledgeable specialist when being evaluated for treatment.

For some patients, the trachea may be widened using a small balloon or dilator to expand the airway. This also may not be a long-term solution.

Treatment options that are generally considered to work long term include stenting and tracheal reconstruction. Stenting includes inserting a small tube of metal or high-density polyethylene or polypropylene mesh into the trachea. This tube then keeps the airway open and allows the patient to breathe more easily.

Reconstruction of the trachea is an option when only a small portion of the trachea is involved. During the procedure, the surgeon removes the damaged portion and joins the remaining ends together.

Tracheal Disease | Michigan Medicine

The trachea (windpipe) is the airway, a tube made up of cartilage (the firm tissue in the ear) which starts just below the larynx (voice box) and continues down behind the breastbone then splits into two smaller tubes, called bronchi, which lead to each lung.

With normal breathing, as air is drawn into the lungs, the trachea grows wider and longer. An unhealthy or abnormal trachea, however, may behave differently. The trachea and bronchi can become narrowed or blocked for various reasons, including birth defects, inflammation, injury, or tumor. These conditions can seriously affect the ability to breathe.

Types of Tracheal Disease

The two most common tracheal disorders are tracheal stenosis and tracheomalacia:

Tracheal Stenosis

Tracheal stenosis is narrowing of the trachea, and as such narrowing occurs, it is more difficult to draw air into the lungs. The degree of tracheal stenosis can range from mild to severe. Patients who have a more severe stenosis may require a tracheostomy tube inserted below the area of obstruction to be able to breathe.

Causes

Tracheal stenosis is most commonly caused by inflammation and scarring that follows intubation, insertion of a breathing tube into the trachea during surgery, or when there is the need for mechanical ventilation (respirator). It can also be caused by:

  • Autoimmune disorders (such as amyloidosis, pulmonary sarcoidosis, Wegener’s granulomatosis)
  • External injury (trauma) to the chest or throat
  • Infections (such as tuberculosis)
  • Radiation therapy
  • Thermal burns /caustic injuries
  • Tumors in or pressing against the trachea

Symptoms

Patients with tracheal stenosis do not always exhibit symptoms.  However, a patient with tracheal stenosis may present with:

  • Asthma (wheezing)
  • Bluish tint to skin color, or in the mucous membrane of nose or mouth
  • Coughing or hoarseness
  • Coughing up blood
  • Difficulty breathing
  • Frequent cases of pneumonia or other upper respiratory infections
  • Respiratory distress
  • Shortness of breath
  • Stridor, or high-pitched breathing sound

Treatment

Depending on the severity, location, length and cause of tracheal stenosis, treatment options will vary. Some of the most common surgical options include the following:

  • Bronchoscopic tracheal dilation: Through a bronchoscope (a light used to examine the inside of the airway), a balloon or tracheal dilator is used to widen (stretch) the trachea, providing immediate relief of the airway obstruction and allowing the thoracic surgeon to precisely identify the extent and severity of the narrowing.
  • Laser bronchoscopy: Through a bronchoscope, scar tissue is burned away with a laser beam; the procedure provides short-term but immediate relief of the obstruction.
  • Tracheobronchial airway stent: The tracheal narrowing is propped open with a fine metallic expandable stent inserted into the airway through a bronchoscope.
  • Tracheal resection and reconstruction: The area of tracheal scarring and constriction is cut away (resected), and the two remaining ends of the trachea sewn back together resulting in an unobstructed airway.

Tracheomalacia

Tracheomalacia is a condition in which the cartilage in the wall of the trachea softens resulting in a floppy or weak airway that collapses with breathing and makes breathing difficult.

Causes

Tracheomalacia has multiple causes. Infants may be born with the disorder, or adults may develop it later on in life. The most common causes of tracheomalacia include:

  • Damage to the trachea or esophagus caused by surgery or other medical procedures
  • Damage caused by a long-term breathing tube or tracheostomy
  • Chronic infections (such as bronchitis)
  • Emphysema
  • Gastroesophageal reflux disease (GERD)
  • Inhaling irritants
  • Polychondritis (inflammation of cartilage in the trachea)

Symptoms

The symptoms of tracheomalacia include:

  • Abnormal/irregular breathing noises (such as high-pitched or rattling sounds)
  • Chronic cough/hoarseness
  • Difficulty swallowing, especially solid foods
  • Recurring respiratory tract infections
  • Shortness of breath

Treatment

In many cases, tracheomalacia gradually improves without any treatment at all as the trachea becomes more rigid and less “floppy”. However, patients who suffer from frequent respiratory infections should be closely monitored. Their options for treatment may include the following:

  • Chest physical therapy: Non-invasive techniques that include lightly tapping on the chest to break up mucus, and deep breathing exercises.
  • Continuous positive airway pressure (CPAP): Through a face mask, air under mild pressure forces the trachea to remain open during breathing.
  • Tracheobronchial airway stent: The trachea is propped open with a thin metallic expandable stent placed into the airway through a bronchoscope.
  • Tracheal resection and reconstruction: After removal of the scarred, floppy portion of the trachea, the remaining ends of the trachea are  joined back together.
  • Tracheoplasty: A surgical procedure that provides support to the weak/floppy trachea, preventing its collapse during breathing. The procedure uses plastic mesh or surrounding tissue as support, and the length of the floppy trachea is sutured to it so that the airway is held in an open configuration during the breathing cycle.
  • Tracheostomy: An incision in the trachea is made, and a tube is inserted into the airway to relieve the obstruction to breathing.

Diagnosis of Tracheal Diseases

After completing a medical history and general physical examination, the physician may perform one or more of the following procedures to determine whether there might be tracheal stenosis or tracheomalacia present:

  • Bronchoscopy—a procedure in which a lighted tube is inserted into the windpipe and allows the physician to examine the inside of the trachea and bronchi (the air passages leading to the lungs). The procedure enables the physician to make a precise diagnosis and measure the length of the abnormal airway segment.
  • Chest X-rays depict the interior of the chest, and CT-scans produce a series of images of the inside of the body, taken from different angles and depths, to reveal a high level of detail, particularly of the trachea and any narrowing or tracheomalacia that may be present. To ensure that the blood vessels and organs show up clearly in these scans, dye may be swallowed or injected into a vein during performance of the scan.
  • Dynamic 3D Chest CT-scans provide more detailed imaging of the area of tracheal narrowing. This is a non-invasive procedure performed with the patient inhaling and exhaling.
  • Pulmonary Function Tests, or PFTs, assess the function and strength of the lungs. For the most common of these, after forcefully blowing  air into a tube, a machine called a spirometer measures the volume of air the patient is able to hold in the lungs, and the speed with which that can be blown out (exhaled). Compared with normal values, an obstructed airway can be identified.

 

Cancer of the trachea – Sore Throat Guide

The trachea or ‘windpipe’
is a long tube which runs from the mouth and nose to the lungs. It resembles
an inverted tree trunk with branches which supply air to the lungs.

These branches are known as ‘bronchi’.

It is located in the neck, in front
of the oesophagus and is comprised of concentric rings of cartilage.
These can be felt if you touch the front of your neck.

Cancer of the trachea is a rare form
of cancer which accounts for a very small percentage of cancer cases.
This is often known as bronchial cancer.

There are several types of tracheal
cancer, for example ‘squamous cell carcinoma’ that develop within
cells that line parts of the body such as the airways and throat.

Causes of cancer of the trachea

As with any type of cancer it is difficult to determine the precise
causes. There is not a single cause of this type of cancer; rather there
are several causes which include:

  • Smoking
  • Exposure to certain chemicals
  • Environmental reasons, e.g.
    exposure to Radon gas
  • Poor diet
  • Poor immune system
  • Family history

Cancer of the trachea appears to affect
middle aged and older people.

Symptoms of cancer of the trachea

The following symptoms can be a sign
of another condition which is less serious than cancer. They include:

  • Hoarseness
  • Breathlessness
  • Dry cough
  • Coughing up blood
  • Repeated chest infections
  • Repeated chills and fevers
  • Wheezing
  • Difficulty in swallowing
  • Weight loss
  • Fatigue

Consult your GP if you notice some
or all of these symptoms.

These may be symptoms of something
else such as a throat infection but it is still important to see your
GP. Do this if these symptoms have been ongoing for a couple of weeks
or more.

Diagnosing cancer of the trachea

Any suspicion of cancer requires further
investigation. However, the initial stage starts with a visit to your
GP. He or she will discuss your symptoms with you and will ask you about
your family history. He/she will also ask about your lifestyle, for
example, do you smoke and will also examine you.

If your GP suspects that you may have
cancer then he or she will refer you to a specialist. This also includes
investigative tests.

Once an appointment has been arranged
you will meet with the specialist. He or she will examine you and ask
you about your medical history before sending you for blood tests. X-rays
will also be carried out.

This is a difficult cancer to diagnose
as the symptoms are very similar to those for asthma or bronchitis.

You may undergo some or all of the
following tests:

  • CT scan
  • MRI scan
  • Bronchoscopy

(Source: Macmillan
Cancer Support
: cancer of the
trachea)

These tests will help the specialist
to determine the type of tracheal cancer you have and the extent. The
word ‘extent’refers to the stage of the cancer or in layman’s
terms –how far it has spread within the body.

The results of these will help him/her
to decide upon a suitable course of treatment for you.

CT scan

A CT scan uses X-rays to obtain a 3D
image of the trachea. These X-rays give an accurate image of the trachea
and throat in general and enable the specialist to determine the extent
of your cancer.

MRI scan

An MRI scan works in a similar way
but uses magnetism instead. It also obtains a series of accurate images
of your trachea which also includes any tumours. This enables the care
team to see how far the cancer has spread.

Bronchoscopy

A bronchoscopy is a form of endoscopy in which a slim, fibre optic tube – with
a light and camera mounted at one end – is inserted into your nose
or mouth and passed down into your trachea.

The specialist is able to gain a closer
look at your trachea to see if there are any growths or similar problems.
He/she may take a biopsy at the same time.

Note: a biopsy is the medical
name for the procedure in which a sample of cells or tissue is taken
from an area of the body for laboratory analysis. This analysis looks
for signs of cancer, e.g. cancerous cells.

There are two types of bronchoscopy:
rigid and flexible. The flexible version involves the use of a telescopic
tube whereas the rigid version is as the name says. It is a stiff type
of tube which allows the specialist a clearer view of your trachea.

Waiting for the results

This is a difficult time for many people.
You will have to wait for a few days or even a week to obtain your results
which can be a stressful and anxious time.

It is natural to fear the worst and
assume that a long wait means that you have cancer but this is not the
case. The length of time you have to wait for your results is the same
whether you have cancer or not.

You may find it helpful to talk to
someone during this time. Your partner, a member of your family or a
close friend will be able to provide a sympathetic shoulder. Another
option is a counselling service or a cancer support group.

There are numerous support groups for
various forms of cancer, which consist of people who have been through
the same experience as you. People within these groups will have gone
through the same emotional stress that you are currently experiencing
and can provide advice and support.

Treatment for cancer of the trachea

Once your results have come back the
next step is to discuss your treatment. This will be done by a multi-disciplinary
team of healthcare professionals which includes a cancer specialist,
dietician, cancer nurse (or nurses), surgeons etc. These people are
highly trained professionals and experienced in their field who are
there to help you.

They will take a variety of factors
into account when devising a suitable programme of treatment for you.
These factors include:

  • Your age
  • Your health/fitness
  • Your lifestyle
  • The extent (or ‘stage’)
    of your cancer
  • The results of the scans,
    X-rays and blood tests

Everyone is different when it comes
to cancer treatment which means that your will be given a treatment
plan which is tailored to your needs and requirements.

The most important factor in this is
the stage of your cancer.

What do we mean by the word ‘stage?’

Medical experts use the term ‘stage’
to refer to how far a cancer has spread. This is defined as a series
of stages from early stage through to advanced stage.

An early stage cancer is easier to
treat than cancer at an advanced stage but there is treatment available
for all stages of cancer.

The team will devise a treatment plan
for you based upon the factors mentioned above which will include some
or all of the following:

  • Surgery
  • Chemotherapy
  • Radiotherapy

Surgery

Surgery is performed to remove small
and large scale tumours. In some cases the trachea is affected to the
extent that a section of it needs to be removed. The remaining sections
are joined together which results in a shorter trachea.

You will do breathing exercises with
a physiotherapist to adapt to this.

Your lymph nodes may also be affected
which will need to be removed at the same time.

This surgery will be followed by a
session of radiotherapy to kill off any remaining cancer cells and stop
them from returning.

Chemotherapy

Chemotherapy uses a series of drugs
to destroy cancer cells. These drugs are extremely powerful and cause
a range of side effects which will be explained to your beforehand.

Chemotherapy is effective at destroying
these cells and preventing the growth of new cells.

Radiotherapy

Radiotherapy uses high energy X-rays
to destroy cancer cells with the aim of minimising any damage to healthy
cells. It is used in cases of early stage cancer or after surgery to
prevent any re-occurrence of the cancer.

One problem with cancer of the trachea
is breathing. If a tumour grows to a large enough size then it can prevent
you from breathing as normal. In this situation you will have one or
a combination of the following treatments:

  • Stent
  • Laser treatment
  • Photodynamic therapy (PDT)
  • Diathermy
  • Cryotherapy

Stent

A stent is a small device, such as
a tube or wire frame which is inserted into the trachea to aid with
breathing. This is done under a general anaesthetic.

Laser treatment

This involves the use of a laser beam
to burn away a tumour. A bronchoscope will be inserted into your trachea
which allows a laser beam to be passed down it in order to destroy the
tumour.

Photodynamic therapy (PDT)

Photodynamic therapy uses a single
method or combination of methods to destroy a tumour. This involves
a light sensitive drug plus a laser to kill cancer cells. The laser
is aimed at the tumour which then allows the light sensitive drug to
destroy the cancerous cells.

Diathermy

This procedure uses heat to kill cancer
cells. An electrically heated probe kills the cancerous cells which
then eases the symptoms.

Cryotherapy

This process uses liquid nitrogen to
freeze and then kill cancer cells (think of cryonics). An instrument
called a ‘cryoprobe’ is placed near a tumour which emits liquid
nitrogen into this to destroy the tumour.

You will continue to have regular follow
up appointments with your care team even after these treatments have
finished. These appointments will start off at regular intervals but
will spread out as time passes.

You will find that you have fewer of
these appointments as time goes by. But if you notice anything untoward
during this time then see your GP as soon as possible.

Causes, symptoms, and pain relief

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Swallowing involves many muscles and nerves in the mouth, throat, and food pipe. Many people will experience pain when swallowing at least once in their lives. The medical term for painful swallowing is odynophagia.

It is often possible to identify the cause of pain when swallowing by looking at the specific symptoms.

Depending on the cause, these may include sharp or dull pain in the jaw, throat, chest, or food pipe. The pain may only affect one side of the throat and can change when a person breathes deeply.

In this article, we take a closer look at the causes and symptoms of painful swallowing. We also look at how to relieve the pain.

Several illnesses and conditions that lead to infection, inflammation, and obstruction of the throat, mouth, or food pipe can cause discomfort swallowing.

Depending on the cause, additional symptoms are often present. The following causes can lead to painful swallowing:

Strep throat

Strep throat, epiglottitis, and esophagitis are some possible causes of pain when swallowing.

Throat infections are one of the most common causes of pain when swallowing. These include strep throat, which is an infection with Streptococcal bacteria.

People with strep throat may also notice:

  • swollen, tender lymph nodes on one or both sides of the neck
  • pain in the soft palate
  • red spots on the soft palate
  • fever
  • white patches on the tonsils

Tonsillitis

Tonsillitis is an infection and inflammation of the tonsils, which are two lymph nodes at the back of the throat. Tonsillitis is a common cause of painful swallowing.

Tonsillitis is a contagious condition. Viruses or bacterial infections, including strep throat, can cause tonsillitis.

If the pain when swallowing is due to tonsillitis, people may also notice:

  • swollen tonsils
  • white or yellow spots on the tonsils
  • bad breath
  • tender jaw or neck
  • fever

Epiglottitis

Epiglottitis is a throat infection that causes inflammation of the epiglottis, which is the flap in the back of the throat that prevents food from going down the windpipe.

In addition to pain when swallowing, typical symptoms of epiglottitis include:

  • difficulty swallowing, known as dysphagia
  • a high fever
  • drooling
  • a preference for sitting leaning forward

A yeast infection

Yeast infections in the mouth, throat, or food pipe can also lead to discomfort swallowing. Yeast is a type of fungus that can grow out of control if the conditions inside the body change in a way that promotes yeast growth.

A bacteria called Candida is a common cause of yeast infections.

Additional symptoms might include:

  • loss of taste
  • white patches on the tongue
  • redness in the corners of the mouth

Esophagitis

The food pipe, also called the esophagus, is the pipe that carries food and liquid from the mouth to the stomach. Esophagitis is inflammation of the esophagus.

The most common cause of esophagitis is gastric reflux disease, which is a condition that allows stomach acid to flow back up the food pipe.

Certain medications and allergic reactions can also cause esophagitis.

Esophagitis can cause the following symptoms alongside painful swallowing:

  • chest pain
  • stomach pain
  • a hoarse voice
  • coughing
  • heartburn
  • nausea

Throat injury

Although less common than other causes, an injury to the throat can also lead to pain when swallowing.

Eating or drinking something that is too hot can burn the inside of the throat or food pipe. People can also scratch or cut the back of their throat when eating a cracker or chip that has a sharp edge.

Depending on the location and extent of the injury, there may only be pain on one side of the throat or further down in the food pipe.

A doctor may use a blood test to diagnose pain when swallowing.

An accurate diagnosis is vital to treat pain when swallowing. Doctors may recommend various tests to make a diagnosis. After reviewing a person’s medical history and carrying out a physical examination, they may perform the following diagnostic tests:

  • Throat culture. During a throat culture, the doctor removes a sample of mucus from the throat with a cotton swab. They test this mucus to determine whether or not it contains any organisms that might be causing an infection.
  • Blood tests. Blood tests, including a white blood cell count, help the doctor determine if an infection is present.
  • Barium swallow. A barium swallow is a special type of X-ray of the food pipe. Before taking the X-ray, the doctor will ask the individual to drink a liquid containing barium. The barium will reveal the pathway that the food takes from the mouth to the stomach.
  • CT scan. Doctors use CT scans to create images of the throat. These help the doctor identify any abnormalities, such as tumors, in the throat or food pipe that might cause painful swallowing.

Treatment for pain when swallowing generally depends on the cause.

Medication is the standard treatment for certain types of infection. Doctors usually recommend antifungal medications to treat yeast infections and antibiotics to treat bacterial infections, including strep throat.

When people have recurring tonsillitis, or it does not respond well to medication, a doctor may recommend removing the tonsils in a procedure called a tonsillectomy.

Sipping warm drinks can provide short-term relief.

People can use the following home remedies for short-term relief from painful swallowing:

  • Taking anti-inflammatories. Nonsteroidal anti-inflammatory medications (NSAIDs) can reduce swelling and inflammation in the mouth, throat, and food pipe, making it easier and less painful to swallow.
  • Taking antacids. Over-the-counter (OTC) antacids are effective for reducing pain that results from acid reflux.
  • Using throat sprays. Throat sprays can numb the throat and make swallowing easier and less painful. These are available OTC or online.
  • Gargling with salt water. Salt water may decrease inflammation and make swallowing less painful. Mix 8 ounces (oz) of warm water with 1 teaspoon (tsp) of salt and gargle this solution several times a day.
  • Sipping warm drinks. Warm drinks, such as herbal tea, may help decrease pain. Avoid making the liquid too hot, or it can burn the throat.
  • Taking a hot shower. The steam from a hot shower may help to decrease any inflammation responsible for painful swallowing.
  • Avoiding alcohol and tobacco. Substances in alcohol and tobacco can irritate the soft tissue of the mouth, throat, and food pipe.

Painful swallowing often resolves in a few days, especially if it occurs due to a cold. However, in some cases, professional medical help is necessary to determine the cause and provide treatment.

It is best to consider seeing a doctor if the following circumstances apply:

  • the cause of pain when swallowing is unknown
  • the pain has lasted more than a week or is getting worse
  • there is a patch of white spots in the back of the throat

It is also important to recognize when painful swallowing can be a sign of a medical emergency. A person should seek immediate medical care if pain when swallowing occurs alongside:

  • swelling of the throat
  • difficulty breathing
  • problems opening the mouth
  • unusual drooling

Although it can be uncomfortable, pain when swallowing is typically only temporary. Depending on the cause, painful swallowing often goes away in a few days.

For example, if the pain is due to a cold, it usually resolves within a week.

If a bacterial or fungal infection is causing the pain, treatment is usually successful. In the meantime, people can use home remedies to manage their symptoms and reduce discomfort.

SHOP FOR HOME REMEDIES

All of the products in this article are available in pharmacies and online.

Read the article in Spanish.

90,000 Tracheitis: Causes, Symptoms, Diagnostic and Treatment Methods

Tracheitis – an inflammatory disease of the trachea, more often of an infectious nature

Tracheitis is accompanied by a paroxysmal dry cough or with the release of thick mucous or mucopurulent sputum, as well as pain behind the sternum during and after coughing.

Reasons

Acute tracheitis

Rarely isolated; it usually occurs in combination with acute rhinitis, pharyngitis and laryngitis.The most common cause of acute tracheitis is a viral infection, less often staphylococcus, streptococcus, etc. The development of tracheitis is facilitated by inhalation of dry, cold or dusty air, irritating vapors and gases.

Chronic tracheitis

May develop from acute. Often it occurs in people who abuse smoking and alcohol, as well as with congestion in the respiratory tract due to emphysema of the lungs, heart disease, kidney disease; it is often caused by chronic inflammatory diseases of the nasal cavity and paranasal sinuses.

Symptoms

The leading symptom of acute inflammation of the trachea is a hacking cough that gets worse at night and in the morning. At first it is dry “barking”, then with the release of thick sputum. In the first days of the disease, it has a slimy character, then it becomes purulent, this is especially characteristic of bacterial or mixed tracheitis. A coughing fit can trigger a deep breath, sudden movement, crying, talking, laughing, screaming, or a change in ambient temperature. When coughing and after the end of the attack, the patient is worried about a sore throat and sternum.In children, rapid and shallow breathing is observed.

Acute onset of the disease is accompanied by a rise in temperature sometimes up to febrile numbers (38.6–39.0 0 C), but subfebrile condition is more often observed (not higher than 37.5 0 C). The temperature rises in the afternoon, towards evening. Symptoms of intoxication are absent or not pronounced. A person gets tired faster than usual, feels weak, weak. But the greatest discomfort is caused by a painful cough, leading to sleep disturbances and pain in the head.

In small children, elderly people or those with problems with the immune system, complications may develop in the form of the spread of inflammation to the alveoli and lung tissue. In this case, bronchiolitis or bronchopneumonia develops.

The main symptom of chronic tracheitis is a strong persistent cough. Moreover, during the day it may not be there. A painful cough begins at night and in the morning, making it difficult for a person to fully rest and recuperate.

Diagnostics

The diagnosis is confirmed after laryngoscopy: the mucous membrane of the trachea is hyperemic, edematous, sometimes there are punctate hemorrhages, an abundance of mucus, tissue infiltration (hypertrophied tracheitis).In a chronic process, the mucous membrane of the trachea is pale gray, thin, there is little mucus, in places crusts (atrophied tracheitis).

During auscultation of the lungs in the initial stage of tracheobronchitis, dry, later – non-sonorous moist fine and medium bubbling rales are heard, scattered over both lungs.

Also for the diagnosis of the disease can be assigned: X-ray and endoscopic studies.

Treatment

Treatment of acute tracheitis should be aimed, first of all, at eliminating the causative and contributing factors to the occurrence of tracheitis.

Without the use of antiviral agents, treatment is mainly symptomatic: mustard plasters on the sternum and between the shoulder blades, antipyretic and anti-inflammatory drugs, hot drinks in small sips, heat inhalations.

In case of symptoms of intoxication or the spread of the process to the lower respiratory tract – sulfa drugs and antibiotics, incl. in the form of aerosols.

If there is no sputum, and the patient has only a dry cough, then it makes sense to take conventional antitussive drugs.

In the event that laboratory analysis has shown that tracheitis is caused by bacteria, then the patient is prescribed antibiotic treatment.

As for the diet, the food should be light and soft in consistency, so as not to further irritate a sore throat. Drinking plenty of warm drinks is also recommended to relieve symptoms and help relieve fever. In some cases, compresses, the use of mustard plasters, inhalations, as well as a number of physiotherapeutic procedures will be effective.

90,000 symptoms and treatment, signs and diagnosis of the disease

Tracheitis is an inflammatory process in the trachea caused by bacterial, viral or fungal infections. Systematic coughing attacks become a distinctive feature of pathology. Cough spasms lead to the separation of copious mucous or mucous-purulent sputum.Patients complain of severe sternum pain before and after an attack.

Treatment of tracheal inflammation is carried out under the supervision of a therapist, but the patient may need consultations with a phthisiatrician, allergist and pulmonologist. Antibacterial, antiviral and antihistamines form the basis of drug therapy. Additional prescriptions include mucolytics, expectorants, and antitussives.

The reasons for the development of tracheitis

Acute tracheitis of infectious genesis occurs due to the ingestion of viruses and bacteria.Most of the pathogenic microflora is not viable in an aggressive environment. Therefore, the main method of infection is contact of a healthy person with a carrier of a viral or bacterial infection.

In some cases, tracheitis develops as a complication of influenza, measles, scarlet fever, or chickenpox. Bacterial tracheitis is the result of pneumococci, staphylococci or streptococci entering the body. Studies of the last 10 years have convincingly proved that the main reason for the development of the inflammatory process in the trachea is conditionally pathogenic microflora, which is constantly present in the respiratory tract.

The development of allergic tracheitis is facilitated by the presence of small particles, tobacco smoke and unfavorable environmental conditions in the patient’s region of residence in the inhaled air. Extremely dry or waterlogged air also has a significant impact. Often city dwellers breathe through the mouth, which excludes preliminary air purification in the nasal cavity. Nasal breathing can be difficult due to rhinitis, sinusitis, curvature of the nasal septum, or adenoids.Systematic hypothermia or irritation of the larynx can lead to the development of chronic tracheitis.

Types of tracheitis

Otolaryngologists distinguish 3 types of the pathology under consideration: infectious, allergic and infectious-allergic. Infectious tracheitis is presented in three variations: viral, bacterial and mixed.

Treatment of tracheitis and symptoms of concomitant diseases is impossible without taking into account the clinical picture. The course of the inflammatory process is considered by doctors as acute or chronic. The first type occurs suddenly, the elimination of inflammation in the trachea occurs within 2 weeks. The chronic form of the disease is characterized by regular exacerbations, which are followed by periods of remission. Launched tracheitis leads to a change in the morphology of the tracheal mucosa.

Symptoms

The main signs of tracheitis are cough and sputum, which is separated during coughing acts.The first days the patient suffers from dry cough. Mucous sputum appears 3-4 days after infection of a child or adult. Coughing fits are accompanied by severe pain syndrome. Cough movements occur involuntarily with deep breaths, loud conversation, hysterical crying or prolonged laughter. Painful sensations persist in the space behind the sternum for a long time. As the inflammatory process develops in the trachea, the amount of sputum separated increases, and its consistency changes.With a bacterial lesion of the respiratory system, the discharge becomes purulent. For this reason, doctors insist on the individual selection of drugs for tracheitis for each patient.

In the first days of the development of the inflammatory process, the patient feels an increase in body temperature. During the day, the indicators come to standard values, in the evening they rise again. Symptoms of tracheitis can vary among individuals of different age groups. Thus, children and adolescents hardly experience intoxication, which significantly worsens the condition of the elderly.Coughing fits provoke sleep disturbance in patients of all ages.

An increase in cervical lymph nodes becomes a characteristic feature of the pathological process in the trachea. When palpated, patients feel mild pain.

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Diagnostic procedures

The therapist directs the patient for a blood test, sampling of throat and nasal swabs (for culture), laryngotracheoscopy (performed by an otolaryngologist).The patient’s sputum is also subjected to laboratory tests. Analyzes make it possible to determine the resistance of the pathogen to antibiotics, which form the basis of drug treatment for tracheitis.

Therapy

Based on the test results, the attending physician prescribes treatment for the patient.For bacterial tracheitis, antibiotics are used, for viral tracheitis, antiviral drugs. The allergic nature of the inflammatory process in the trachea becomes the reason for prescribing antihistamines to a child or adult. Expectorants and mucolytics help remove phlegm from the patient’s respiratory system. In the chronic type of tracheitis, persons suffering from seasonal exacerbations receive immunomodulatory drugs.

Questions and answers

Answers to frequently asked questions:

Sinebogov

Stanislav Vladimirovich

Experience of 25 years

Otolaryngologist for adults and children

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How to avoid the transition of acute tracheitis into the chronic stage?

Stanislav Vladimirovich Synbogov

Otorhinolaryngologist of the highest category, candidate of medical sciences, member of the European Rhinologic Sociaty

It is possible to prevent the transition of an acute pathology to a chronic one only with the timely start of treatment.The patient should follow all the prescriptions of the therapist or otolaryngologist and do not reduce the recommended daily dosage of drugs. Consultation will be useful

What is the danger of chronic tracheitis?

Stanislav Vladimirovich Synbogov

Otorhinolaryngologist of the highest category, candidate of medical sciences, member of the European Rhinologic Sociaty

Chronic pathologies have a significant impact on the quality of life of people.Seasonal exacerbations of tracheitis force patients to spend time on visits to doctors, and money on buying the necessary drugs. Coughing attacks and pain syndrome negatively

90,000 Tracheitis – symptoms and treatment

Tracheitis is an inflammatory disease of the tracheal mucosa, which is accompanied by a dry, paroxysmal cough. The coughing fits are worse at night.The nature of tracheitis is usually infectious.

Tracheitis rarely occurs singly and is usually complicated by inflammation of the nasopharynx, rhinitis, laryngitis, and even bronchitis. The course of tracheitis can be acute and chronic. Acute tracheitis is characterized by more pronounced symptoms, but after two weeks, recovery occurs, although the process can become chronic.

Tracheitis is classified according to the etiology:

  • Bacterial
  • Viral
  • Mixed etiology
  • Allergic
  • Infectious

It is the etiology of the disease that dictates the tactics of treating tracheitis and self-medication is unacceptable.


Symptoms of Tracheitis

A characteristic symptom of the disease is a dry, tearful cough, which causes severe discomfort. Aggravation occurs at night and early in the morning. During coughing, patients feel severe pain in the throat and behind the sternum, so they try to restrict breathing, and it becomes frequent and shallow. When laughing, crying, or a change in temperature, the cough worsens. The accumulation of phlegm causes a severe attack.

At the same time, the body temperature almost does not rise, usually not more than subfebrile (up to 37.5), but in children it can rise even higher in the evening. The expectoration is difficult and very viscous. After the third day, the sputum becomes more, it liquefies and leaves more easily, which gives relief to the patient, since the attacks are no longer accompanied by such discomfort and pain as at the beginning of the disease.

When the inflammatory process captures the bronchi, the disease flows into tracheobronchitis.

Chronic tracheitis is accompanied by a debilitating cough at night for a long time.When the patient coughs, the patient feels pain in the chest, the sputum can be either scanty or abundant, but it is separated more easily.

Treatment of tracheitis

To alleviate the patient’s condition, it is necessary to eliminate the factors contributing to irritation of the mucous membrane, which causes a painful cough.

Inhalation and alkaline drinking eases the patient’s condition. For inhalations, a special inhaler is used, if there is no device, then they are made over the steam, covered with a towel.Hot milk with soda or warmed alkaline mineral water is given.

Mustard plasters on the chest and back and rubbing help with illness. In case of difficult sputum discharge, the therapist prescribes expectorants, and if the attacks are painful, then drugs with codeine are prescribed. If the infection has descended into the lower respiratory tract, then the therapist prescribes antibiotics.

Menzhevitskaya Tatyana Ivanovna

causes, symptoms, diagnosis and treatment

Tracheitis is a pathological process that affects the trachea, develops as a result of exposure to bacterial, viral or fungal infections.

Tracheitis is characterized by a dry cough, the attacks of which regularly bother the patient. At the first symptoms of tracheal inflammation, you should immediately make an appointment with an otolaryngologist, who will conduct the necessary studies and prescribe appropriate treatment.

Reasons for the development of tracheitis

Acute tracheitis develops due to exposure to the trachea of ​​pathogens. A healthy person becomes infected with pathogenic microflora upon contact with a sick person – this is the main route of infection.Sometimes, inflammation is a complication of respiratory diseases. In addition, allergens, tobacco smoke, poor ecology, poor air quality, systematic hypothermia and various factors irritating the throat can be the cause of the disease.

Acute tracheitis

Acute inflammatory process almost always proceeds against the background of rhinitis, pharyngitis and laryngitis. Cough is caused by exposure to pathogenic viruses and bacteria, and in some cases, symptoms of tracheitis are caused by dry, cold or dusty air, irritating vapors and gases.

Chronic tracheitis

The chronic course of the disease develops with untimely access to a doctor, smoking, alcohol abuse. In addition, chronic tracheitis occurs in combination with other diseases affecting the respiratory tract.

Symptoms

The main symptoms of tracheitis in children and adults are sore throat, cough and sputum production. The onset of the inflammatory process is characterized by an increase in temperature, the appearance of a dry cough, which is subsequently accompanied by the release of sputum and intense pain.If the respiratory system is infected with bacteria, the discharge may be purulent. A characteristic feature of tracheitis is enlarged cervical lymph nodes.

Diagnostics

Diagnosis of tracheitis is based on a comprehensive examination, blood analysis, collection of smears and sputum, laryngotracheoscopy. After receiving complete information about the patient’s health status and test results, the otolaryngologist prescribes the most effective course of treatment.

Treatment

Treatment of tracheitis in children and adults is carried out in a comprehensive manner, which allows you to eliminate the causes that contribute to the onset of the inflammatory process.Symptomatic therapy is aimed at combating various negative signs of pathology: drugs are used to relieve fever and inflammation.

If there is intoxication and the active spread of inflammation in the respiratory tract, doctors use sulfa drugs and antibiotics. In the absence of phlegm, cough medicine will help cure the disease.

Treatment of tracheitis at home requires correction of the diet: the patient needs light and soft food that does not irritate the throat.In addition, physicians successfully use physiotherapy in the complex treatment of patients.

Prevention

Symptoms and treatment of tracheitis can be avoided by following some of the recommendations of otolaryngologists:

  • if you smoke, you must quit;
  • you should limit your stay in places where the atmospheric air is heavily polluted;
  • it is recommended to visit balneological sanatoriums and resorts;
  • if you have a sore throat and other symptoms of respiratory diseases, you should immediately consult a doctor and start treatment;
  • you need to devote time to the prevention of hypovitaminosis, good rest and the fight against chronic diseases.

Tracheitis is not a trifle

The pharynx and nose are the gateway for most viruses (ARVI), which often cause respiratory disorders such as runny nose, sore throat, pharyngitis, cough … If a person does not quite effectively cope with the infection, it can spread deeper, and then tracheitis develops. Chronic foci of bacterial infection in the nasopharynx – tonsillitis, sinusitis – can also cause inflammation of the tracheal mucosa, especially after hypothermia or fatigue, inhalation of cold, dry or dusty air.

Usually symptoms of acute tracheitis appear after catarrhal inflammation of the overlying parts of the respiratory tract. The most characteristic symptom is a dry, excruciating cough at night and especially in the morning, aggravated by a deep breath, laughter, crying, and a change in air temperature. During an attack, the patient feels a raw pain and burning sensation behind the sternum and in the throat, breathing becomes rapid and shallow. If not treated appropriately, the cough continues for several weeks.In some cases, there is a hoarseness of the voice (due to concomitant laryngitis), sometimes so strong that it is difficult to speak. The phlegm is at first viscous, mucous in nature and leaves in small quantities, but gradually becomes more abundant, mucopurulent in nature and is separated more easily, thereby reducing the intensity of pain when coughing. The general condition, as a rule, does not suffer: there is a slight increase in body temperature and slight malaise. However, this does not mean that the disease can be ignored or self-medicated.It is not so rare that the inflammatory process also captures the bronchi, then the clinical picture takes on the character of tracheobronchitis: the cough becomes more painful and constant, the fever progresses, intoxication increases. The most frequent and severe complication of the disease is bronchopneumonia, which is especially dangerous for the elderly and children.

Since the symptoms of a common cold, acute tracheobronchitis and pneumonia are very similar, the final diagnosis can only be made by a doctor, which usually requires additional studies, both laboratory and radiological.

Whatever the clinical manifestations of tracheitis, it is very important to start timely treatment so that the disease does not give complications and does not turn into a chronic form. Reasons for seeking medical help:

• cough that does not go away for several days;

• difficulty in breathing;

• persistent temperature rise or its repeated rise;

• wheezing and chest pain;

• the appearance of pus and blood in the sputum.

After the diagnosis is established, the patient is prescribed a home regimen, warming procedures, abundant (up to 1.5 – 2 liters per day) warm drink: tea with lemon, decoctions and infusions of medicinal plants (chamomile, sage, mint, coltsfoot, licorice, marshmallow root), juices, fruit drinks.If necessary, it is allowed to take antipyretic drugs (at a body temperature above 38 ° C). Antibiotics are indicated only when a bacterial infection is attached!

In the fight against cough, breathing exercises and vibration massage of the chest, which are best done in the morning, immediately after waking up, are very effective. Steam inhalations (including with the help of a nebulizer), hot foot baths (with a water temperature of no higher than 42 – 43 ° C), as well as humidification of the air and periodic (for 10 – 15 minutes 2 – 3 times a day) through ventilation of the room.

Although modern medicines help to cure almost any form of airway inflammation, it is better to prevent the disease. To do this, at least one should adhere to the rules of a healthy lifestyle: eat rationally, be in the fresh air more often, avoid overwork and stress, quit smoking and alcohol abuse, do not overcool, treat colds and chronic diseases in a timely manner.

Vladimir Khryshchanovich, Doctor of Medical Sciences, Professor
Soviet Belarus , 23 April 2020

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90,000 Causes, Symptoms, Diseases, Diagnosis and Treatment

It is necessary to talk about the presence of pain in the trachea when the pain sensations appear deeper than the zone of the tonsils.

Pain in the trachea is a fairly common symptom at a medical appointment (Photo navimed.ua)

Why is there pain in the trachea?

Pain in the trachea occurs when the trachea is damaged or ill. Most often, internal tracheal injury occurs as a result of a foreign object falling into the throat . Such cases are quite common in childhood, when a child swallows small toys, hard pieces of food or other objects.External tracheal injuries occur with all sorts of injuries, for example, when the neck is squeezed or penetrating wounds. The situation when there is a foreign object in the trachea is extremely dangerous, should immediately call an ambulance .
Among the diseases accompanied by the appearance of pain syndrome in the trachea, the most common is tracheitis . Tracheitis is characterized not only by pain that occurs at the slightest attempt to clear the throat, but also hoarseness, hoarseness of the voice. Bacteria, viruses, allergies and inhalation of chemically active substances can be the cause of the development of tracheitis.

Severe pain in the trachea – causes

Severe pain, accompanied by swelling of the ligaments, difficulty breathing, a sharp “barking” cough and a significant increase in temperature occurs with laryngotracheitis . In some cases, the symptoms of laryngotracheitis are so intense that they can lead to suffocation. This disease is especially dangerous in young children.
Severe pain in the trachea, accompanied by strained dry cough, shortness of breath, sputum production is observed with tracheobronchitis .Tracheobronchitis can develop as a complication of an inflammatory disease of the upper respiratory tract, or as an independent disease. Self-treatment of laryngotracheitis and tracheobronchitis is not permissible, since these diseases can cause various serious complications, including bronchial obstruction. It is necessary to consult a pediatrician (if a child is ill) or a therapist.
Tracheal pain syndrome occurs with malignant neoplasms . However, it should be remembered that tracheal cancer develops asymptomatically for a long time, and, like a benign tumor, manifests itself only with difficulty breathing.At first, shortness of breath worries only after physical exertion, then it appears at rest, and as the disease progresses, patients can breathe relatively freely only in a sitting position. If you experience shortness of breath and pain in the trachea, you should visit an oncologist.


Authors:

Shidlovsky Ivan

MD, Physician – neurologist, doctor of ultrasound diagnostics and Doppler ultrasound. 15 years of experience. Project Manager. Author and editor of medical texts

Contact phone number for the consultation: +380970152152

90,000 Tracheitis: causes, symptoms and treatment

This is an inflammatory disease of the tracheal mucosa.It rarely occurs on its own. Most often he is accompanied by a cold. A predisposing factor for the development of inflammation in the trachea is inhalation of cold air, general hypothermia of the body. Tracheitis is one of the symptoms of flu.

The most common cause of tracheitis is a viral infection. Once on the mucous membrane of the trachea, viruses cause damage to it, which is accompanied by irritation, pain and inflammation. Less commonly, tracheitis is bacterial.

Tracheitis can also be toxic: it develops through smoking, inhalation of toxic and irritating substances, paint fumes, gasoline and other chemicals.People prone to allergies may develop tracheitis in a dusty room. The tendency to tracheitis is increased in people who regularly consume alcohol.

Symptoms of tracheitis

The main symptom of tracheitis is a dry, hacking cough. Coughing fits are excruciating and unproductive (phlegm is not coughing up at all or in very small quantities).

Cough with tracheitis worse at night, during sleep, and in the morning. Cough can be provoked by cold or hot air, tobacco smoke, drinking mucous irritating drinks, eating nuts, chocolate, honey or citrus fruits, screaming, laughing and deep breathing.

Constant coughing causes soreness in the chest, pain along the intercostal muscles and diaphragm, soreness behind the breastbone. In rare cases, coughing fits with tracheitis can lead to vomiting or short-term loss of consciousness.

In addition to coughing, tracheitis is sometimes accompanied by general symptoms: fatigue, weakness, nervousness, fever, sweating.

Treatment of tracheitis

In the treatment of tracheitis, the regimen and lifestyle of the patient are of great importance.For a speedy recovery, you need to avoid being in the cold, in a smoky room, and quit smoking.

Do not eat too hot and too cold food and drink, only moderately warm. Rough food that can injure the pharyngeal mucosa, which reflexively causes coughing attacks, should be excluded from the menu.

A temporary taboo should be imposed on the use of spices and seasonings, marinades and spices. During tracheitis, nuts, citrus fruits, chocolate and coffee are prohibited.With honey and beekeeping products, everything is individual: depending on the sensitivity of the body, honey can intensify the manifestations of tracheitis, and maybe accelerate recovery by relieving coughing attacks.

Butter for tracheitis treatment

It is very useful for tracheitis to soften the throat with butter. To do this, you can brew fatty tea, as is customary in Central Asia – add two teaspoons of sugar, a pinch of ginger powder and a slice of natural butter to a mug of warm tea, stir and drink in large sips.Oil coats the mucous membrane, relieving irritation, and ginger helps to get rid of cough.

Milk for tracheitis treatment

An attack of nocturnal cough, especially in young children, can be relieved with hot milk (this is the only hot drink permitted). Persuade a coughing child to drink a glass in one gulp. You can add a pinch of baking soda to it. This procedure will provide relief and help you fall asleep.

Aromatherapy for tracheitis

Inhalation of eucalyptus, fir, ginger, juniper and pine vapors has a beneficial effect on tracheitis.