Eur J Cardiothorac Surg 2005;27:705
© 2005 Elsevier Science NL
Images in cardio-thoracic surgery |
Fixed and dynamic airway obstruction in polychondritis
Babu T. Muntimadugu,
Peter Goldstraw*
Department of Thoracic Surgery, Royal Brompton Hospital, London SW3 6NP, UK
Received 31 August 2004;
received in revised form 29 December 2004;
accepted 3 January 2005.
* Corresponding author. Tel.: +44 20 7351 8559; fax: +44 20 7351 8560. (E-mail: p.goldstraw{at}rbh.nthames.nhs.uk).
Key Words: Polychondritis • Dynamic airway obstruction • Tracheal cartilage
A 42 year old female presented with cough, arthralgia, dyspnoea and a staccato cough. CT scan (Fig. 1) and Bronchoscopy (Fig. 2) showed fixed tracheal stenosis and a dynamic component on passive expiration due to posterior wall motion. She received Predniosolone and Azathioprine and stenting was considered the possible next step.
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Fig. 1. CT scan during inspiration (A) and passive expiration (B) showing thickening of tracheal cartilages encroaching upon the tracheal lumen and further narrowing during passive expiration due to posterior wall motion.
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Fig. 2. Bronchoscopic view of trachea at the level of cricoid during inspiration (A) and passive expiration (B) showing near occlusion of airway in expiration due to anterior motion of membranous part of trachea. These appearances were greatly exaggerated during coughing. [Images at differing levels in the airway have been chosen to give the best impression of this phenomenon.]
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