Investigations and treatment
On the basis of history, examination and imaging the diagnosis of sub-glottic stenosis was made and for accurate pre-operative assessment of site, length and degree of stenosis, rigid bronchoscopy was done under general anesthesia. However, to our surprise a betel nut measuring 2×1 cm2, covered with mucin, blackish debris and granulation tissues was found in the tracheal lumen just above the carina with no evidence of subglottic stenosis (Figure 2 and 3). The betel nut was then removed followed by disappearance of stridor and ease in breathing.