Repeated Tracheostomy Tube Cuff Rupture Due to Tracheobronchopathia Osteochondroplastica: A Case Report

Document Type : Case Report

Authors

1 Department of Anesthesia and Critical Care, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Department of Pulmonary and Critical Care, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Department of Cardiothoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

4 Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Introduction:
Tracheobronchopathia osteochondroplastica (TPO) is a rare benign disorder of the lower part of the trachea and the upper part of the main bronchi.
 
Case Report:
A case of tracheobronchopathia osteochondroplastica (TPO) diagnosed at the time of intubation in an intensive care unit due to difficulty when advancing the endotracheal tube beyond the vocal cords, is reported. A problem was encountered which had not been reported previously in TPO: repeated cuff rupture at the time of surgical tracheostomy occurred possibly because of bony and cartilaginous tissue located in the tracheal wall.
 
Conclusion: 
In addition to difficulty of intubation, TPO may cause tracheostomy tube cuff rupture, which could be explained due to bonny calcification in the tracheal wall. 

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Main Subjects


1. Smith DC, Pillat R, Gillbe CE. Tracheopathia osteochondroplastica. A cause of unexpected difficulty intracheal intubation. Anesthesia 1987; 42(5): 536-8.
2. Bergeron D, Cormier Y, Desmeules M. Tracheo- bronchopathia osteo-chondroplastica. Am Rev Respir Dis 1976; 114(4): 803-6.
3. Lundgren R, Stjernberg NL. Tracheo broncho- pathia osteochondroplastica. A clinical bronchoscopic and spirometric study Chest 1981; 80(6): 706-9.
4. Hantous-Zannad S, Sebai L, Zidi A, Ben khelil J, Mestiri I, Besbes Me, et al. Tracheobronchopathia osteochondroplastica presenting as a respiratory insufficiency: diagnosis by bronchoscopy and MRI. Eur J Radiol 2003; 45(2):113–6.
5. Coëtmeur D, Bovyn G, Leroux P, Niel-Duriez M. Tracheobronchopathia osteochondroplastica presenting at the time of a difficult intubation. Respir Med 1997; 91(8):496-8.
6. Gurunathan U. Tracheobronchopathia osteochondroplastica: a rare cause of difficult intubation. Br J Anaesth 2010; 104:787-8.
7. Tadjeddein A, Khorgami Z, Akhlaghi H. Tracheo- bronchopathia osteoplastica: cause of difficult tracheal intubation. Ann Thorac Surg 2006; 81(4):1480-2.
8. Eckhardt WF , Forman S, Denman W, Grillo HC, Muehrcke D. Another use for the laryngeal mask airway--as a blocker during tracheoplasty. Anesth Analg 1995; 80(3):622-4.