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Tracheobronchomalacia: an unusual cause of debilitating dyspnoea and its surgical management
  1. Kathryn Mulryan1,
  2. James O'Connor2,
  3. Michael Egan3 and
  4. Karen Redmond1
  1. 1Department of Thoracic Surgery, The Mater Misericordiae University Hospital, Dublin, Ireland
  2. 2Department of Thoracic Surgery, Beacon Hospital, Sandyford, Dublin, Ireland
  3. 3Department of Intensive Care Medicine and Anaesthesia, Beacon Hospital, Sandyford, Dublin, Ireland
  1. Correspondence to Dr Kathryn Mulryan; Mulryak{at}tcd.ie

Abstract

Tracheobronchomalacia (TBM) is a progressive weakening of the airways, leading to collapse and dyspnoea. TBM can be misdiagnosed when multiple chronic conditions accompany it. Tracheobronchoplasty (TBP) is indicated for severe symptomatic TBM, diagnosed by bronchoscopy and CT thorax. We report the case of a patient who underwent tracheal resection and reconstruction for continuing dyspnoea post argon therapy, TBP and a failure to tolerate extracorporeal membrane oxygenation-assisted Y-stent insertion. Relevant background history includes asthma, sleep apnoea, reflux, cardiomyopathy and a high body mass index. Bronchoscopy postreconstruction showed patent airways. Airway reconstruction was a viable management option for this patient’s TBM. TBP is a treatment option for TBM. In this case, tracheal resection was required to sustain benefit. In addition, surveillance bronchoscopies will be carried out every year.

  • Anaesthesia
  • Cardiothoracic surgery

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: KM, JO'C, ME, KR. The following authors gave final approval of the manuscript: KM, JO'C, ME, KR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.