Tracheobronchopathia osteochondroplastica: a rare tracheal lesion in a free-ranging grizzly bear

A mature male grizzly bear ( Ursus arctos) that died of blunt-force trauma had numerous hard 1–3-mm nodules protruding from tracheal rings into the lumen of the distal trachea. Histologically, these were round aggregates of mature cartilage within the submucosa. Such lesions are consistent with tracheobronchopathia osteochondroplastica, a rare tracheal disease in humans and animals.

Tracheobronchoscopic, cytological and microbiological results of tracheal and bronchial collapse in dogs

The aim of this study was to evaluate the tracheobronchoscopic, cytological and microbiological results of tracheal and bronchial collapse in dogs. In total, 8 dogs were included in the study. Clinically, tracheal palpations of the dogs were reflective of tracheal disease, and all dogs coughed on tracheal palpation. Vital parameters and hematological values of the dogs were within the normal ranges. Radiological views of the respiratory tracts and thorax were largely normal, but distinctive tracheal contours were noted in cases 3 and 6. Tracheobronchoscopy was performed under general anesthesia, and endoscopic findings (mucosal surfaces and color, prominent appearance of vessels, chondral ring abnormalities of the trachea, and the presence of bronchial and tracheal collapse) were scored. Bronchoalveolar lavage (BAL) was performed to collect samples for cytological and microbiological analysis. Five cases had tracheal collapse, and two cases had right bronchial collapse. Concurrent tracheal and right bronchial collapse were diagnosed in one case. Cytological results were not indicative of inflammation or infection, but Escherichia coli was isolated from case 2 (bronchial collapse) and case 3 (tracheal collapse). Antibiotic susceptibility results revealed that the organisms were susceptible to sulfamethoxazole/trimethoprim. Statistically, there were no significant differences between the cases in terms of total endoscopic scores. In conclusion, tracheal and/or bronchial collapse should only be diagnosed by tracheobronchoscopic examination. Cytological and microbiological analyses of the BAL fluid in these cases do not always provide valuable data for clinical practitioners. .

Neonatal Tracheal and Intracardiac Repair in a High-Risk Premature Infant Requiring Preoperative ECMO Transport

Congenital tracheal stenosis is an uncommon malformation that portends a poor outcome in children who are symptomatic in the neonatal period. Over time, the management of significant tracheal disease has been consolidated at high-volume centers, and increasingly complex patients have undergone surgical repair. We present a premature newborn boy who was diagnosed with critical multi-level airway and cardiac disease who decompensated at a remote site, requiring extracorporeal membrane oxygenation support for transport. He underwent a complete repair including a slide tracheoplasty and was successfully discharged home, with no residual stenosis at follow-up.

Laryngeal Preservation in Managing Advanced Tracheal Adenoid Cystic Carcinoma

A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally.