Primary tracheal amyloidosis (PTA) can lead to airway obstructions, and patients with severe PTA should undergo bronchoscopic interventions in order to maintain airway patency. Focal airway involvements with amyloidosis can only be treated with mechanical dilatation. However, the PTA with diffused airway involvements and concomitant cartilage destructions requires stent placement. Limited information regarding the usefulness of silicone stents in patients with PTA has been released. Therefore, we report a case of diffused PTA with tracheomalacia causing severe cartilage destruction, which is being successfully managed with bronchoscopic interventions and silicone stent placements.
Airway Obstruction ; Amyloidosis* ; Bronchoscopy ; Cartilage* ; Dilatation ; Humans ; Silicones* ; Stents* ; Tracheomalacia

Open heart surgery in a patient with tracheostoma by standard median sternotomy increases the risk of wound infection or mediastinitis. In adults, the risk of mediastinal infection is decreased by using the high tracheostomy and minimally invasive approach for cardiac surgery. However the modified surgical approach is needed in infants due to their short neck. We have successfully performed the closure of ventricular septal defect, using the transverse sternotomy, in an infant with tracheostoma due to tracheomalacia.
Adult ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Mediastinitis ; Neck ; Sternotomy ; Thoracic Surgery ; Tracheomalacia ; Tracheostomy ; Wound Infection

Congenital tracheomalacia associated esophageal atresia is a rare foregut anomaly. We report a case of 40-day old male infant with tracheomalacia who has undergone repair of esophageal atresia at his age of 1 day. The patient had progressive dyspnea and stridor after repair of esophageal atresia. His 3-dimensional chest computed tomography showed severe stenosis at the middle of trachea. We underwent resection and end-to-end anastomosis under cardiopulmonary bypass. Histologic examination revealed esophageal tissues indicating congenital origin as well as no cartilage.
Cardiopulmonary Bypass ; Cartilage ; Constriction, Pathologic ; Dyspnea ; Esophageal Atresia* ; Humans ; Infant ; Male ; Respiratory Sounds ; Thorax ; Trachea ; Tracheomalacia*

Congenital tracheomalacia associated esophageal atresia is a rare foregut anomaly. We report a case of 40-day old male infant with tracheomalacia who has undergone repair of esophageal atresia at his age of 1 day. The patient had progressive dyspnea and stridor after repair of esophageal atresia. His 3-dimensional chest computed tomography showed severe stenosis at the middle of trachea. We underwent resection and end-to-end anastomosis under cardiopulmonary bypass. Histologic examination revealed esophageal tissues indicating congenital origin as well as no cartilage.
Cardiopulmonary Bypass ; Cartilage ; Constriction, Pathologic ; Dyspnea ; Esophageal Atresia* ; Humans ; Infant ; Male ; Respiratory Sounds ; Thorax ; Trachea ; Tracheomalacia*

Tracheomalacia is an uncommon disease but an important cause of respiratory distress in children. Tracheomalacia is often associated with other defects, such as esophageal atresia, tracheoesophageal fistula or paratracheal tumor. Rigid bronscopy is used to confirm tracheomalacia, and aortopexy may be applied for surgical intervention. We experienced a case of a 10 month old male infant with tracheomalacia who had undergone tracheoesophageal fistula correction 2 days after birth. Tracheomalacia was diagnosed under rigid bronchoscopy, and the tracheal wall was compressed in accordance with respiration. After aortopexy, the patient breathed smoothly and was discharged after 9 days uneventfully. Aortopexy does not seem to be familiar with pediatric anesthesiologists. We report this case with references as we were unable to find any case report about this maneuver.
Bronchoscopy ; Child* ; Esophageal Atresia ; Humans ; Infant ; Male ; Parturition ; Respiration ; Tracheoesophageal Fistula ; Tracheomalacia*

Although laryngomalacia is the most common cause of congenital stridor in infancy, it is a benign, self-limited disease which usually resolves by the age of 18 months with no long- term sequelae. Nevertheless, infants who suffered from recurrent stridor and respiratory distress should be evaluated for other causes of stridor such as cardiopulmonary anomalies. We report 3 cases of infants who had recurrent stridor and respiratory distress from their early infancy. Case 1 had a double aortic arch and a tracheomalacia, case 2 had a hypoplasia of the right lung, and case 3 had a horseshoe lung as well as scimitar syndrome. Physicians should be alert for the possibility of the congenital cardiopulmonary abnormalities in infants with recurrent stridor and/or respiratory distress.
Aorta, Thoracic ; Dyspnea ; Humans ; Infant ; Laryngomalacia ; Lung ; Respiratory Sounds ; Scimitar Syndrome ; Tracheomalacia

This is a case of tracheomalacia associated with esophageal atresia. An 11-month-old- male boy presented with a life-threatening apneic spell after correction of esophageal atresia (Gross type C). After complete exclusion of the other possible causes of the apneic spell, the presumptive diagnosis of tracheomalacia was made with fluoroscopy and 3-dimensional chest CT. The final diagnosis was made with rigid bronchoscopy under spontaneous respiration. The aortopexy was performed with intraoperative bronchoscopic examination. The postoperative period was unremarkably uneventful. The patient was discharged 9 days after the aortopexy and has remained well to date (5 months after the aortopexy).
Bronchoscopy ; Diagnosis ; Esophageal Atresia* ; Fluoroscopy ; Humans ; Male ; Postoperative Period ; Respiration ; Tomography, X-Ray Computed ; Tracheomalacia*

The complications of endotracheal intubation are inevitable, of which postintubation tracheal stenosis may be required for surgical resection with primary reconstruction. Before surgery, several less invasive therapeutic modalites including bougie dilatation, stenting, and Nd-YAG laser incision are still available in use. Especially, good results were noted in selected patients with lengthy scars of less than 1cm and without tracheomalacia using endoscopic laser incision and dilatation. We report a case of a 54 yr-old woman with postintubation tracheal stenosis who was successfully treated by endoscopic Nd-YAG laser incision and esophageal balloon catheter.
Catheters* ; Cicatrix ; Dilatation ; Female ; Humans ; Intubation, Intratracheal ; Lasers, Solid-State* ; Stents ; Tracheal Stenosis* ; Tracheomalacia

Tracheomalacia is characterized by weakness of the tracheal walls and supporting cartilage. It results in dynamic compression of the airway, where the cross-sectional area of the trachea is reduced by expiratory compression. Acquired tracheomalacia results from complications associated with the use of endotracheal or tracheostomy tubes. In this report, we present three cases of patients with amyotrophic lateral sclerosis (ALS) successfully treated for tracheomalacia, including one case where the patient underwent surgery for combined tracheoesophageal fistula. We discuss the appropriate management strategies for tracheomalacia in patients with ALS. Through these case reports, we note the results of ALS patients who will have tracheostomy, and who are therefore at risk of sustaining a long term high cuff pressure, this study provides an evaluation for tracheomalacia and therapeutic management which should be considered for improving patient care outcomes.
Amyotrophic Lateral Sclerosis* ; Cartilage ; Humans ; Patient Care ; Trachea ; Tracheoesophageal Fistula ; Tracheomalacia* ; Tracheostomy

In cases of intellectually disabled patients, there is sometimes difficult to obtain sufficient information due to the intellectual disorder, even though the patient has significant medical problems. Herein, we report a case of decreased oxygen saturation and inadequate air exchange during general anesthesia in an intellectually disabled patient. We also describe the subsequent management, including the diagnosis of tracheomalacia (TM) using bronchoscopy, and the management of airway compromise with manual and/or controlled respiration, which led to the prevention of complications.
Airway Management ; Anesthesia, General ; Bronchoscopes ; Bronchoscopy ; Diagnosis ; Humans ; Oxygen ; Respiration ; Tracheomalacia