Introduction: Tracheal stenosis can be severe and life-threatening. Treatment of tracheal stenosis remains complex, not standardized, and multidisciplinary.

Objective: We aim to determine the different management modalities of acquired tracheal stenosis and propose a therapeutic algorithm for this entity.

Patients and methods: We conducted a retrospective and descriptive study based on the medical records of tracheal stenosis cases managed in our department during a ten-year period starting from 2009 to 2019.

Results: Our study included 47 patients. They all had a history of hospitalization at intensive care units during a mean period of 18 days. A tracheoscopy was performed on all patients. It revealed that, in 53 % of cases, the stenosis was classified as a grade 3 or 4 of the Myers-Cotton classification. Endoscopic tracheal dilation using the rigid bronchoscope was performed in 32 patients; it was followed by a clinical improvement in 24 of them. Diode laser was used in 68% of patients and resulted in a decrease in symptoms. Fourteen patients (30 %) rather underwent a tracheal resection with an end-to-end anastomosis after a mean period of 21 months. Surgical success was noted in 11 patients while 3 patients required reoperation due to stenosis recurrence with satisfying results in 2 of them. After a mean follow-up period of 52 months, the mortality rate was 10%. We noted that 64 % of patients did not have dyspnea.

Conclusion: Endoscopic procedures remain the first step of tracheal stenosis management. Tracheal resection with end-to-end anastomosis is indicated either in complex tracheal stenosis cases or following the failure of endoscopic procedures