A 33-year-old immunocompetent female patient was hospitalized in
the emergency department after the rupture of an intracerebral angioma.
Percutaneous tracheostomy was performed at 14 days. The endoscopy
performed 9 days later showed no abnormality in the trachea. At 30
days, glottic edema developed, but it was difficult to assess the
portion below the tracheal tube because the patient was agitated.
Extubation was considered at 40 days, as the patient’s neurologic and
respiratory condition had improved. Blocking off the tube induced
asphyxia. Endoscopy was performed under general anesthesia, showing
impassable tracheal stenosis. The MRI showed thin stenosis, and removal
of the obstruction with CO2 laser exposed a
tracheal ring impacted in the trachea. Surgical tracheostomy was
performed with resection of the anterior part of the ring. However, at
9 days, stenosis reformed and a Montgomery T-tube had to be inserted.
It was removed 6 months later, but after 2 weeks stenosis reformed
again and tracheal anastomotic resection was performed. Now, the
patient has no stenosis and her trachea is normal.