Trachea

Tracheal diverticulum: A report of 4 cases

January 1, 2009     B.G. Sharma, MD
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Abstract

Tracheal diverticulum is a rare entity. When it does occur, it is usually discovered incidentally in an asymptomatic patient as an outpouching from the tracheal wall, usually on the right side. It can be either congenital or acquired. A tracheal diverticulum may act as a reservoir for secretions that may spill over into the tracheobronchial tree, predisposing affected patients to cough, dyspnea, stridor, and chronic chest infection. The author describes 4 cases of tracheal diverticulum—3 congenital and 1 acquired—that were discovered on chest x-ray. The congenital form was found incidentally in 3 asymptomatic middle-aged women, and the acquired case (a tracheobronchial diverticulum) was discovered during a workup for chronic cough and fever in a young man. All 4 patients were thoroughly evaluated with conventional chest and neck radiographs, barium-swallow imaging, linear tomography, computed tomography, and magnetic resonance imaging. Resection of these tracheal diverticula was not considered for any patient. The author also reviews the literature on tracheal diverticulum.

Intratracheal ectopic thyroid tissue presenting with protracted airway obstruction: A case report

July 31, 2008     Mo Khan, MD, Peter G. Michaelson, MD, Major, USAF, MC, FS, and Michael L. Hinni, MD
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Abstract

Intratracheal ectopic thyroid tissue is a rare finding, with few cases reported in the literature. Ectopic thyroid tissue results when the thyroid gland fails to descend to its final position during early development. These lesions present in various locations, and the clinician should be aware of their existence and presenting signs and symptoms.

Tracheal diverticulum: A rare finding in a patient with worsening chronic cough

July 31, 2008     Gregory P. Danielson, MD, Veronika Jedlovszky, MD, and Gary P. Landrigan, MD
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Abstract

Acquired tracheal diverticulum is a rare clinical entity with only limited reports in the literature. We report a case of a tracheal diverticulum that was identified as part of a work-up for a worsening cough. In this case the diverticulum was observed 2 years after surgical management of a retropharyngeal abscess. It was felt that pooling of secretions in the acquired pouch was a contributing factor in the exacerbation of the patient's chronic cough. Because of the patient's extensive comorbidities, observation and serial computed tomography scans were recommended.

Near-complete tracheal ring deformity: A case report

June 30, 2008     Melissa L. Somers, MD and Dana L. Suskind, MD
article

Abstract

Long-segment near-complete tracheal ring deformity is a rare condition with few documented cases. We present the case of a 7-week-old male with total anomalous pulmonary venous return and long-segment near-complete tracheal rings. We discuss the presentation, evaluation, and management of near-complete and complete tracheal rings.

Adult-onset iatrogenic tracheomalacia

May 31, 2008     Christopher Y. Chang, MD and James P. Thomas, MD
article

Pleomorphic adenoma of the trachea

April 30, 2008     Michael J. Rodriguez, MD, Giovana R. Thomas, MD, and Uzma Farooq, MD
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Abstract

Primary pleomorphic adenoma of the trachea is rare, as only 33 cases have been previously reported worldwide since 1922. We describe a new case of primary tracheal pleomorphic adenoma that was discovered incidentally in a 78-year-old man. The tumor was excised, and the patient recovered without complication. Salivary gland tumors of the trachea should be considered in the differential diagnosis of tracheal lesions; the diagnosis is confirmed by pathologic evaluation. Patients are adequately treated with sleeve resection and primary anastomosis whenever possible.

Formation of an airway foreign body during removal of a metal tracheostomy tube: A case report

March 1, 2008     Mitchell R. Gore, PhD and Austin S. Rose, MD
article

Abstract

Tracheostomy tube changes are often performed in the clinic or at the bedside without complication. We report a case in which the removal of a long-term metal tube in a clinic setting was complicated by the presence of fibrinous debris on the tube. The debris had accumulated over a period of at least 3 years. The patient was taken to the operating room, and the tube was removed. However, the fibrinous debris remained behind, leaving an airway foreign body. The foreign body was subsequently removed with an optical foreign-body extraction forceps under direct visualization. Based on our experience and on the limited amount of information available in the literature, we recommend that long-term metal tracheostomy tubes be changed not in the clinic but in the operating room, where potential complications can be more easily managed.

Views of a type I posterior glottic stenosis before and after lysis

August 31, 2007     Melinda Davis-Malesevich, BS; Albert Merati, MD
article

Posterior glottic stenosis (PGS) can be devastating. It is estimated to occur in 4% of patients who have been intubated for 1 week and in 14% of those who have been intubated for up to 2 weeks.

Preventing posterior tracheal wall perforation in percutaneous

August 31, 2007     Jason S. Hamilton, MD; Sofia Avitia, MD; Ryan F. Osborne, MD, FACS
article

A 49-year-old woman with a history of orthotopic liver transplantation was admitted to the intensive care unit for respiratory failure requiring intubation. She had graft-versus-host disease and fever of unknown origin. The patient was unable to be weaned from ventilator support, so the ICU team performed a percutaneous dilational tracheotomy (PDT) under bronchoscopic guidance.

Aspirated tracheobronchial foreign bodies: A Jordanian experience

February 1, 2007     Tareq Mahafza, FRCS; Yousef Khader, ScD
article
 

Blood-but not bleeding-at a tracheotomy site: A case of Munchausen's syndrome

September 30, 2006     Bart Patenaude, MD; Robert Zitsch III, MD; Scot D. Hirschi, MD
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Abstract
Munchausen's syndrome is a factitious illness in which patients fabricate medical problems in order to receive medical attention. Their "symptoms" are typical of actual medical conditions and their history is dramatic yet plausible, but no pathology can be found on imaging and other investigations. We report the case of a young woman whose Munchausen's syndrome manifested as purported bleeding from a tracheotomy site. In actuality, she had drawn the blood from an arm vein and spattered it on her neck.

Infantile supraglottic hemangioma: A case report

May 31, 2006     Mehmet Ada, MD; M. Güven Güvenç, MD; Süleyman Yilmaz, MD
article
Abstract
Hemangiomas of the airway are benign vascular lesions that can involve any site from the nares to the tracheobronchial tree. Most of these lesions are seen in the subglottic area in infants. Supraglottic infantile hemangiomas are very rare. We report a case of supraglottic hemangioma in a 2-month-old boy who had been admitted to our hospital with inspiratory stridor and dyspnea. The hemangioma involved the left arytenoid and aryepiglottic fold. A tracheostomy was performed, and the patient was followed up endoscopically every 6 months thereafter. The hemangioma disappeared when the child was 30 months old. Subsequently, a Montgomery T-tube was placed for 6 months to assist in maintaining normal breathing. The patient remains disease-free during ongoing follow-up. We also discuss the management strategies for infantile laryngeal hemangiomas.
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