This study aims to develop a CT-based scoring system to help predict whether patients with tracheal stenosis will require surgical treatment or can be managed with endoscopic procedures. Using retrospective data, researchers will evaluate CT scans of patients diagnosed with tracheal stenosis to measure features such as airway diameter, wall thickness, and tissue density (measured in Hounsfield Units). The goal is to create a non-invasive, reproducible, and objective tool-called the Tracheal Stenosis Morphology and Attenuation Score (TSMAS)-that can support clinical decision-making and improve treatment planning.

Inclusion Criteria:

• Age ≥ 18 years
• Diagnosed with tracheal stenosis
• Underwent thoracic CT imaging at the time of diagnosis
• CT scans available in adequate quality and in DICOM format
• No prior surgical treatment for tracheal stenosis before CT imaging

Exclusion Criteria:

• Tracheal stenosis due to malignancy, foreign body, or tracheobronchial tumors
• History of tracheal surgery before CT imaging
• Poor quality CT images (e.g., motion artifacts, incomplete tracheal segments)
• Patients with a history of radiotherapy (RT) to the neck or mediastinum

The study population consists of adult patients (aged 18 and older) diagnosed with tracheal stenosis, who underwent thoracic CT imaging at the time of diagnosis. All patients were treated or followed at Ondokuz Mayıs University Hospital between 2000 and 2025. Only patients with sufficient-quality DICOM-format CT scans and no prior tracheal surgery or radiotherapy were included.