Abstract
To study the clinical presentation, management and mechanism of fractured outer metallic tracheostomy tube presenting as tracheobronchial foreign body. A retrospective chart review patients with fracture outer metallic tracheostomy tube. Data regarding the patients’ demographic data, diagnosis, clinical presentation, type of tracheostomy tube and site of fracture were analyzed. Total 4 cases of fracture outer metallic tracheostomy tube were found. There were 3 males and 1 female, average age 52.75 years, range 31–76 years. The common presentation were dyspnea, intolerable cough and decreased breath sound in 4(100%), 2(50%) and 2(50%) cases. The most serious presentation was cardiac arrested 1 case. The dislodged tube were retrieved by flexible and rigid bronchoscopy. The most common site of fracture were outer tube at mid shaft 3 cases (75%). All of this site had corrosion. Only 1 case (25%) was fracture at junction between neck plate and tube without corrosion. The average time of usage metallic tracheostomy tube was 24 days, range 3–34 days. Fracture tracheostomy tube is rare and serious medical emergency. The patients, caregivers and physicians should recognition and prompt action. Flexible or rigid bronchoscopy via tracheostoma can successfully removal the dislodge part. The mechanism of fracture may come from several factors. The defective manufacturer, stagnation of alkaline bronchial secretion, recurrence process of removal, cleaning and boiling of the tube can cause mechanical stress and degradation of passive film of the tubes. The patient education regarding the maintenance and regular checked up can possibly extinguish this complication.
Similar content being viewed by others
References
Stauffer JL, Olson DE, Petty TL (1981) Complication and consequences of endotracheal tube intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med 70:65–76
Piromchai P, Lertchanaruengrit P, Vatansapt P, Ratanaanekchai T, Thanaviratananich S (2010) Fracture metallic tracheosotmy tube in a child: a case report and review of the literature. J Med Case Rep 4:234–237
Radpay B, Pejhan S, Dabir S, Parsa T, Radpay MZ (2009) Fracture and aspiration of tracheostomy tube. Tanaffos 8:75–78
Bassoe HH, Boe J (1960) Broken tracheotomy tube as a foreign body. Lancet 1:1006–1007
Kemper BL, Rosica N, Myers EN, Sparkman T (1972) Inner migration of the inner cannula: an unusual foreign body. Eye Ear Nose Throat Mon 51:257–258
Alvi A, Zahtz GD (1994) Fracture of a synthetic fenestrated tracheotomy tube: case report and review of the literature. Am J Otolaryngol 15:63–67
Brockhurst PJ, Feltoe BE (1990) Corrosion and fracture of a silver tracheotomy tube. J Laryngol Otol 104:48–49
Ming CC, Ghani SA (1989) Fractured tracheotomy tube in the tracheobronchial tree. J Laryngol Otol 103:335–336
Parida PK, Kalaiarasi R, Gopalakrishman S, Saxena SK (2014) Fractured and migrated tracheotomy tube in the tracheobronchial tree. Int J Pediatr Otorhinolaryngol 78:1472–1475
Bhargava SK, Bhat N, Bhargava KB (1993) Broken tracheostomy introducer—an unusual tracheobronchial foreign body. J Laryngol Otol 107:463–464
Lynrah ZA, Goyal S, Goyal A, Lyngdoh NM, Shunyu NB, Baruah B, Dass R, Yunus M, Bhattacharyya P (2012) Fractured tracheostomy tube as foreign body bronchus: our experience with three cases. Int J Pediatr Otorhinolaryngol 7:1691–1695
Majid AA (1989) Fractured silver tracheostomy tube: a case report and literature review. Singap Med J 30:602–604
Gana PN, Takwoingi YM (2000) Fractured tracheostomy tubes in the tracheobronchial tree of a child. Int J Pediatr Otorhinolaryngol 53:45–48
Srirompotong S, Kraitrakul S (2001) Fractured inner tracheostomy tube: an unusual tracheobronchial foreign body. Srinagarind Med J 16:223–225
Krempl GA, Otto RA (1999) Fracture at fenestration of synthetic tracheostomy tube resulting in a tracheobronchial airway foreign body. South Med J 92:526–528
Kakar PK, Saharia PS (1972) An unusual foreign body in the tracheo-bronchial tree. J Laryngol Otol 86:1155–1157
Al-Momani HM, Alzaben K, Mismar A (2015) Upper airway obstruction by a fragmented tracheostomy tube: case report and review literature. Int J Surg Case Rep 17:146–147
Gupta SL, Swaminathan S, Ramya R, Parida S (2016) Fractured tracheostomy tube presenting as a foreign body in a paediatric patient. BMJ Case Rep. https://doi.org/10.1136/bcr-2015-213963
Krishnamurthy A, Vijayalakshmi R (2012) Broken tracheostomy tube: a fractured mandate. J Emerg Trauma Shock 5:97
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors confirm that there are no known conflict of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. This manuscript and the data it contain have not been previously published or submitted for simultaneous consideration to this or another journal.
Ethical Approval
The Institutional Review Board of the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand has approved this study by IRB No. 207/60.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Mahattanasakul, P., Kaewkongka, T., Sriprasart, T. et al. Fracture Outer Metallic Tracheostomy Tube as an Airway Foreign Body. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 1752–1756 (2022). https://doi.org/10.1007/s12070-019-01744-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-019-01744-5