Surgical treatment of expiratory stenosis

Objective. To demonstrate the effectiveness of surgical treatment for complicated expiratory tracheal stenosis. Material and methods. The authors present anamnestic data, symptoms, diagnostic approaches, surgical features and outcomes in a patient with expiratory tracheal stenosis and syncopal episodes. Conclusion. Expiratory tracheal stenosis remains an underdiagnosed and underestimated condition. Primary etiopathogenetic factor is excessive intrathoracic pressure during exhalation. The gold standard for diagnosis is tracheobronchoscopy. Imaging techniques are useful only in dynamic formats. Conservative therapy (anti-inflammatory, mucolytic and bronchodilators), including positive end-expiratory pressure (PEEP) ventilation, is effective for most patients, but should be considered as a palliative measure. Surgical treatment aimed at posterior tracheal wall reinforcement is indicated for complications such as syncopal episodes, severe barking cough, and impaired social functioning. Minimally invasive techniques are available and appropriate for expiratory tracheal stenosis. Long-term outcomes depend on consistent lifelong pulmonological care.