Abstract
We report a case of 53-year-old man with secondary tracheomalacia successfully treated by tracheal resection and reconstruction. He suffered a traumatic brain injury and had a tracheostomy from the age of 2 years to 8 years. At 51 years, he had repeated dying spells, exemplified by choking with cyanosis. We diagnosed secondary tracheomalacia using rigid bronchoscopy. The lesion was limited to the second and third tracheal cartilages. We performed tracheal resection and reconstruction via a cervical approach with a collar incision of the neck. The sternum and the innominate artery lay at the lesion's caudal side; therefore, we did not interfere with those structures. Annular excision and end-to-end anastomosis of the first and fourth tracheal cartilages were performed. He had been under sedation for 5 days, and 6 days after the operation, his endotracheal tube was removed. The postoperative course was uneventful, and his dying spell disappeared. Tracheal resection and reconstruction are useful in cases of secondary tracheomalacia, especially in cases in which the lesion is limited to the upper trachea.
