Journal of Yeungnam Medical Science

Case Reports

Tracheal pleomorphic adenoma with coexisting pulmonary tuberculoma: Jehun Kim, Chul-Ho Oak, Tae-Won Jang, Mann-Hong Jung; Yeungnam Univ J Med. 2018;35(1):114-120. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.114

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Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

Citations

Citations to this article as recorded by

Pleomorphic adenoma of the trachea: A case report
Mayu Inomata, Shoei Kuroki, Nobuyuki Oguri, Yuichiro Sato, Fumiya Kawano, Ryo Maeda
International Journal of Surgery Case Reports.2023; 109: 108499. CrossRef
Pleomorphic adenoma of the trachea: A case report and review of the literature
Qian-Nuan Liao, Ze-Kui Fang, Shu-Bing Chen, Hui-Zhen Fan, Li-Chang Chen, Xi-Ping Wu, Xi He, Hua-Peng Yu
World Journal of Clinical Cases.2020; 8(23): 6021. CrossRef
Pleomorphic adenoma of the trachea: A case report and review of the literature
Qian-Nuan Liao, Ze-Kui Fang, Shu-Bing Chen, Hui-Zhen Fan, Li-Chang Chen, Xi-Ping Wu, Xi He, Hua-Peng Yu
World Journal of Clinical Cases.2020; 8(23): 6026. CrossRef
Obstructive tracheal neoplasm
Badreeddine Alami, Saïd Boujraf, Mohamed Smahi, Mounia Serraj, Moulay Youssef Alaoui Lamrani, Meryem Boubbou, Mustapha Maaroufi
Formosan Journal of Surgery.2019; 52(3): 92. CrossRef

A Case of Eosinophilic Bronchitis Associated with Tracheal Diverticulum.: Seung Hoon Yoo, Jae Ho Chung, Byung Soo Kang, Won Sik Kang, Won Jun Koh, Min Kyung Lee, Chan Sub Park; Yeungnam Univ J Med. 2011;28(2):192-195. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.192

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Abstract PDF: Tracheal diverticulum is relatively rare. It results from congenital or acquired weakness of the tracheal wall. Most cases are asymptomatic, but when symptoms are present, they are usually nonspecific. A 54-year-old man complained of sputum lasting for several months. Chest computed tomography showed an air-containing cystic structure in the trachea. Fiberoptic bronchoscopy demonstrated ostium arising from the right posterolateral wall at the trachea. Reported herein is a case of eosinophilic bronchitis associated with tracheal diverticulum.

Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet.: Gul Jung, Woo Mok Byun, Hyung Jun Lim, Jong Gyun Kim, Dong Min Kwak, Deok Hee Lee, Sae Yeon Kim, Sun Ok Song, Il Sook Seo, Dae Lim Jee, Heung Dae Kim, Dae Pal Park; Yeungnam Univ J Med. 2007;24(2):344-344. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.344

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Abstract PDF: Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack-Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.

Original Article

The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation.: Deok Hee Lee, Il Chi Kwon; Yeungnam Univ J Med. 2007;24(2):154-161. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.154

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Abstract PDF: BACKGROUND
This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. MATERIALS AND METHODS: For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. RESULTS: The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a SpO2<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). CONCLUSION: In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.

Case Report

Ventilation Impairment During Anesthesia in Patients with Anterior Mediastinal Mass.: Kibum Bum Park, Sang Jin Park, Dae Lim Jee, Bo Hyun Lee; Yeungnam Univ J Med. 2005;22(1):104-112. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.104

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Abstract PDF: Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation

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