An unusual case of upper airways obstruction: What if it's not asthma?

Abstract

Tracheal stenosis poses a diagnostic challenge that can mimic other respiratory pathologies, particularly bronchial asthma. It is characterized by a narrowing of the tracheal lumen, leading to respiratory symptoms such as dyspnea, cough, and wheezing. However, these manifestations can overlap with those of bronchial asthma, making the differential diagnosis a challenging yet crucial task for an appropriate therapeutic approach. This study aimsed to underscore the importance of a comprehensive clinical approach, using bronchoscopy and global spirometry with bronchodilator reversibility testing, to differentiate tracheal stenosis from bronchial asthma, thereby contributing to accurate and timely surgical treatment. Bronchoscopy stands as a cornerstone in investigating tracheal stenosis, allowing for a direct assessment of the site, extent, and nature of the stenosis. Endoscopic observation of the morphological characteristics of the stenosis, such as concentric narrowing or mucosal irregularities, can guide precise diagnosis. Asthma, characterized by reversible bronchial obstruction, responds positively to bronchodilators, compared with a minimal response in the context of tracheal stenosis.