PURPOSE: We report our institutional experience with diagnosis and clinical management of TO.
METHODS: : Between the years of 2000–2006, medical records of patients with TO were studied at the Interventional Pulmonary unit of Tracheal Disease Research Center at Masih Daneshvary Hospital, a referral center for respiratory diseases in Tehran, Iran. We analyzed and studied patients’ demographics, symptom presentation, radiographic appearance, bronchoscopic findings, and their subsequent treatment.
RESULTS: Of the 8760 patients who underwent flexible bronchoscopy (FOB) at our center over a span of 6 years, 10 were diagnosed with TO: their median age was 51 years (16–68 years) and 6 were men. Computerized Tomography (CT) appearance revealed mucosal irregularity and calcified nodules. Histopathologic examination of tissue biopsy through bronchoscopy was used for definitive diagnosis of TO. Bronchoscopy findings revealed the endobronchial lesions to be firm and glossy. Cartilaginous nodules were present in central airways. Treatment included endobronchial Nd: YAG laser photo evaporation (LPE) (n=10), coring of the lesions with the tip of the rigid bronchoscope (n=4), and endobronchial stent placement (n=1). Symptoms were considerably relieved in 6 cases but there was no significant improvement noted in 3 patients. One patient died after 6 years of treatment and follow up.
CONCLUSION: TO is a rare disease and the diagnosis should be suspected based on CT-scan findings or bronchoscopic examination of the airways. Histopathologic examination is required for confirmation of diagnosis. Treatment is palliative and it includes LPE, coring through rigid bronchoscope, and endobronchial stent placement.
CLINICAL IMPLICATIONS: There was no complication in our study.
DISCLOSURE: Hamidreza Jabbardarjani, None.