Case report
Tracheobronchopathia Osteoplastica: Cause of Difficult Tracheal Intubation

https://doi.org/10.1016/j.athoracsur.2005.04.013Get rights and content

Tracheobronchopathia osteochondroplastica is a rare benign disorder affecting the trachea and the bronchi. We report a case presenting as difficulty during tracheal intubation. Chest roentgenogram revealed nothing before surgery. Findings on computed tomographic imaging scans show calcified nodular densities protruding into the tracheal lumen, with an abnormally irregular tracheal morphology and decreased lateral diameter. The fiber optic bronchoscopy, which was unable to pass more than 4 to 5 cm, showed enormous prominent protrusion with significant narrowing of the tracheal lumen. The diagnosis was confirmed by virtual bronchoscopy, which showed a tracheal narrowing with a beaded appearance and an irregular border that extended into the trachea and main bronchi.

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Comment

Tracheobronchopathia osteochondroplastica is a rare, benign condition and is characterized by the presence of bony and cartilaginous nodules in the tracheal and bronchial mucosa [1]. This was first described by Wilks (a physician at Guy’s Hospital in 1875) when he found at autopsy that the larynx, trachea, and bronchi of a 38-year-old man (who had died of tuberculosis) was covered with a number of bony plates. He also noted that these bony deposits were predominately anterior to the trachea and

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    2015, Egyptian Journal of Anaesthesia
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    Till such time that more case reports are brought forward and more studies are done into the etiopathogenesis of this condition, the urgency of the surgery and the severity of the condition guide the management of the patient. In one case report surgery scheduled under general anesthesia was canceled as intubation had been impossible and anesthesia induction was reversed [9]. Awareness of this entity and its anticipation in patients with colorectal carcinoma may help anesthetists to manage similar cases appropriately in the future [10].

  • Tracheobronchopathia osteochondroplastica and difficult intubation: Case report and perioperative recommendations for anesthesiologists

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    However, it is probable that most patients are asymptomatic, as TPO is most often noted as an incidental finding at autopsy [1]. Very rarely is TPO diagnosed secondary to difficult intubation [2–5]. There is little information about the pathogenesis of this condition.

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