Ann Rehabil Med.  2018 Apr;42(2):368-371. 10.5535/arm.2018.42.2.368.

Successful Management of Acquired Tracheomalacia of Patients With Amyotrophic Lateral Sclerosis: A Report of Three Cases

• Yang JH
• Kim TW
• Lee BJ
• Yoon JA
• Shin MJ
• Shin YB

• KMID: 2432210
• DOI: http://doi.org/10.5535/arm.2018.42.2.368

Abstract

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.

Keyword

Amyotrophic lateral sclerosis; Tracheomalacia; Tracheoesophageal fistula

MeSH Terms

Amyotrophic Lateral Sclerosis*
Cartilage
Humans
Patient Care
Trachea
Tracheoesophageal Fistula
Tracheomalacia*
Tracheostomy

Figure

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  Fig. 1 Enlarged diameter of trachea (33.6 mm×37.5 mm) in inspiration computed tomography scan. A yellow arrow is a maximal transverse diameter (33.6 mm); red arrow, a maximal sagittal diameter (37.5 mm); white arrow head, tracheoesophageal fistula on tracheal level.

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  Fig. 2 Enlarged diameter of the trachea (28.66 mm×24.39 mm) with abscess formation and increase in soft tissue density at the posterior aspect of tracheostomy site in computed tomography view. A yellow arrow is a maximal transverse diameter (28.66 mm); red arrow, a maximal sagittal diameter (24.39 mm); white arrow head, abscess on tracheal level.

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