An unusual case of upper airways obstruction

Tracheal stenosis poses a diagnostic challenge that can mimic other respiratory pathologies, particularly bronchial asthma. It is characterized by a narrowing of the tracheal caliber, 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 aims to underscore the importance of a comprehensive clinical approach, utilizing 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 towards a more precise diagnosis. Asthma, characterized by a reversible bronchial obstruction, responds positively to bronchodilators, whereas tracheal stenosis shows a limited or absent response.