A 62-Year-Old Woman With Refractory Wheezing

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A 62-Year-Old Woman With Refractory Wheezing Abhishek Biswas, MD, Hiren J. Mehta, MD, Michael A. Jantz, MD CHEST Volume 153, Issue 3, Pages e57-e62 (March 2018) DOI: 10.1016/j.chest.2017.08.019 Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 1 Flow-volume curve demonstrating a flattened inspiratory and expiratory loop suggestive of a fixed obstructive defect. CHEST 2018 153, e57-e62DOI: (10.1016/j.chest.2017.08.019) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 2 A, CT scan of the trachea demonstrates partial obstruction of the trachea at the level of the thyroid with invagination of the posterior membrane and adhesion to the anterior tracheal wall. B, Tracheal stenosis more distally involving left lateral tracheal wall and anterior tracheal wall. C, Coronal section of tracheal stenosis. (D) Three-dimensional airway reconstruction from posterior view. CHEST 2018 153, e57-e62DOI: (10.1016/j.chest.2017.08.019) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 3 A, Bronchoscopy revealing greater than 90% obstruction of the trachea at the subglottic level with adhesions between the posterior wall and the left lateral and anterior tracheal walls. B, Slit-like orifice at the distal end of the stenosis. C, Proposed electrocautery knife resection of adhesions between posterior membrane and left lateral and anterior tracheal walls (white arrowheads) and proposed radial incisions of cicatricial stenosis component at 10:00 and 2:00 (black arrowheads). D, The tracheal stenosis following electrocautery knife resection and balloon dilation and is now greater than 90% of a normal tracheal diameter. CHEST 2018 153, e57-e62DOI: (10.1016/j.chest.2017.08.019) Copyright © 2017 American College of Chest Physicians Terms and Conditions