Two cases with tracheomalacia

Abstract

Tracheomalacia is a difficult to manage condition. The symptoms are similar to those of COPD and asthma patients. This may cause misdiagnosis. Herein, we present two tracheomalacia cases who received no benefit from inhaled treatment. The patients were examined via computed tomography (CT), bronchoscopy, and polysomnography. The first case was a 83-year-old male having a 50 package-year smoking history. He applied to the hospital due to coughing and followed for COPD. Obstructive sleep apnea was detected via polysomnography. Despite increased positive pressure, the apneas did not heal. On CT, tracheal flattening and tracheal ring and cartilages deterioration were detected. The patient had no sleep apnea one year after stenting. The second case was a 66-year-old male having inhaled treatment for five years for chronic coughing. In bronchoscopy, anterior and posterior parts of trachea were seen to cleave into each other in expiration. Since his tracheomalacia was not life-threatening, he has taken under follow-up. Key words: Apnea, cough, tracheomalacia, sleep.Tracheomalacia in adults is a severe disease which is very difficult to manage and treat. It causes frequent infections and mortality. Although there are no standardized techniques or criteria for the diagnosis of tracheomalacia, previously published articles recommend thoracic CT and bronchoscopy (1-3). The treatment approach is complex. There is no requirement in the treatment of mild asymptoTrakeomalazi yönetimi zor olan ciddi bir hastalıktır. Bu hastaların muayene bulguları KOAH ve astım hastalarına benzerdir. Bu nedenle tanıda yanılmaya sebep olabilir. Bu çalışmada, inhaler tedavilerden fayda görmeyen iki trakeomalazi olgusunu sunmayı amaçladık. Hastalar bilgisayarlı tomografi, bronkoskopi ve polisomnografi ile değerlendirildi. Birinci olgu 83 yaşında erkek hasta idi. Elli paket-yıl sigara anamnezi vardı. Hasta öksürük şikâyeti nedeni ile hastanelere başvurmuş ve 10 yıldır KOAH tanısıyla takip edilmişti. Polisomnografi ile uykuda obstrüktif apneleri tespit edildi. Arttırılan pozitif basınca rağmen apneleri düzelmedi. Bilgisayarlı tomografi ile trakeada yassılaşma, trakeal halka ve kıkırdaklarda bozulma tespit edildi. Trakeal stent takılan hastanın birinci yılın sonunda uyku apnesi yoktu. İkinci olgu beş yıl boyunca kronik öksürük nedeniyle farklı inhaler tedaviler verilen 66 yaşında bir erkek hastaydı. Hastanın öksürüğü sert ve gürültülü idi ve uyku apnesi yoktu. Bronkoskopide expiryumda trakeanın ön ve arka duvarının birbirine yapıştığı görüldü. Trakeomalazisi hayatı tehdit etmediğinden takibe alındı.Anahtar Sözcükler: Apne, trakeomalazi, öksürük, uyku. matic cases. The history for determining the etiology, physical analysis, radiological, and bronchoscopic examination are of utmost importance for the treatment (4). In this article, we evaluated the symptoms, diagnostic methods, and treatments of two patients who were admitted to our clinic for chronic cough and were diagnosed through computed tomography (CT) and bronchoscopy.