Tracheobronchial Stenosis, Congenital

Congenital tracheobronchial stenosis is rare. Tracheobronchial malformations appear to be the result of a defect or arrest in the development of the foregut at stages 13-15 of embryonic development at around 4 to 6 weeks. In many instances, tracheobronchial abnormalities are part of a syndrome. Wong et al. (1998) described monozygotic twin girls concordant for congenital tracheobronchial stenosis. They presented as outpatients at the age of 6 months for evaluation of noisy breathing and frequent wheezing episodes since birth. Using direct coronal CT scan and 3-dimensional reconstruction of the airway, congenital tracheobronchial stenosis was demonstrated in both babies and later confirmed by fiber optic bronchoscopy. Except for wheezing, the twins did not show significant signs of respiratory embarrassment. Tack and Perlman (1987) described severe congenital tracheal stenosis in 2 infants born to diabetic mothers. In lambs, congenital tracheal stenosis is induced by maternal ingestion of Veratrum californicum (Keeler et al., 1985).