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Devaraja K, Surendra VU. Clinicopathological Features and Management Principles of Tracheobronchopathia Osteochondroplastica - A Scoping Review. Indian J Otolaryngol Head Neck Surg 2023; 75:3798-3814. [PMID: 37974722 PMCID: PMC10646011 DOI: 10.1007/s12070-023-03998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 06/16/2023] [Indexed: 11/19/2023] Open
Abstract
Tracheobronchopathia osteochondroplastica (TO) is an orphan disease of the tracheobronchial tree without any known etiological attributes. There are several case reports published on this condition, yet the available information about the TO is discrete and of little clinical value. This scoping review is the first large-scale review on TO that collates individual patient data from the published case reports and descriptively analyses the clinicopathological features of this unique condition along with its management approaches and therapeutic outcomes. The objective was to synthesize comprehensive literature review on TO that can aid clinical practice and further research. An electronic search conducted in five large databases, including PubMed, EMBASE, CINAHL, CENTRAL, and Web of Science, for the published articles of TO yielded 1072 items. After screening, the individual patient data of 371 TO cases from 228 eligible articles were included and analysed in this scoping review. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03998-6.
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Affiliation(s)
- K Devaraja
- Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Vyshak Uddur Surendra
- Department of Respiratory Medicine, Yenapoya Medical College Yenapoya University, Mangalore, Karnataka 575018 India
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García CA, Sangiovanni S, Zúñiga-Restrepo V, Morales EI, Sua LF, Fernández-Trujillo L. Tracheobronchopathia Osteochondroplastica-Clinical, Radiological, and Endoscopic Correlation: Case Series and Literature Review. J Investig Med High Impact Case Rep 2021; 8:2324709620921609. [PMID: 32406259 PMCID: PMC7238787 DOI: 10.1177/2324709620921609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic and benign disease that is often underdiagnosed. TO is characterized by multiple submucosal cartilaginous and osseous tracheobronchial nodules that spare the posterior wall. It usually affects the elderly, developing when the person is around 60 years old without gender preference and has a reported incidence of 0.11%. TO can be symptomatic and should be considered in patients with chronic cough, dyspnea, and recurrent pulmonary infections. Diagnosis is usually incidental by computed tomography or bronchoscopy, the latter being the gold standard diagnostic test for TO. Many thoracic imagers are not well acquainted with TO; thus, these patients are often underdiagnosed or misdiagnosed. We came across 5 patients in our institution who were incidentally diagnosed with TO, inspiring us to review the available literature on this disease. A total of 33 patients diagnosed with TO between 2009 and 2019 were identified by our retrospective review. Clinical and imaging data were collected on these patients. We also included the clinical, radiological, and endoscopic data of our 5 cases. TO should be considered in patients with chronic cough, dyspnea, and recurrent pulmonary infections. Our experience is that both computed tomography and bronchoscopy can be used to make a reliable diagnosis. It is crucial for physicians, especially radiologists and pulmonologists, to be aware of the existence of TO in order to ensure proper diagnosis.
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Affiliation(s)
| | | | | | | | - Luz Fernanda Sua
- Fundación Valle del Lili, Cali, Colombia.,Universidad Icesi, Cali, Colombia
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Sakaguchi Y, Matsumoto K, Nishioka K, Iizuka N, Hirayama Y, Kitaoka A, Tanimura K, Takahashi KI, Kato M. Bronchoscopic Surgery for a Solitary Tracheal Tumor of Tracheobronchopathia Osteochondroplastica. Ann Thorac Surg 2019; 109:e419-e421. [PMID: 31606516 DOI: 10.1016/j.athoracsur.2019.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 11/29/2022]
Abstract
Tracheobronchopathia osteochondroplastica is a rare benign condition in which multiple cartilaginous or bony submucosal nodules project into the trachea or bronchi. A 71-year-old man complained of cough for 3 months. Computed tomography scanning revealed a calcified tracheal tumor near the tracheal bifurcation. Pulmonary function testing indicated airflow limitation, and bronchoscopic examination confirmed a solitary rigid tumor. Bronchoscopic resection was performed under general anesthesia, and the tumor was detached by cauterizing its stem with high-frequency coagulation. The tumor was pathologically indicative of tracheobronchopathia osteochondroplastica. After surgery, the clinical signs of cough and dyspnea resolved and pulmonary function normalized.
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Affiliation(s)
- Yasuto Sakaguchi
- Department of Thoracic Surgery, Kishiwada City Hospital, Osaka, Japan.
| | - Kazuya Matsumoto
- Department of Thoracic Surgery, Kishiwada City Hospital, Osaka, Japan
| | - Kensuke Nishioka
- Department of Respiratory Medicine, Kishiwada City Hospital, Osaka, Japan
| | | | - Yutaka Hirayama
- Department of Respiratory Medicine, Kishiwada City Hospital, Osaka, Japan
| | - Aya Kitaoka
- Department of Respiratory Medicine, Kishiwada City Hospital, Osaka, Japan
| | - Kazuya Tanimura
- Department of Respiratory Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Ken-Ichi Takahashi
- Department of Respiratory Medicine, Kishiwada City Hospital, Osaka, Japan
| | - Motokazu Kato
- Department of Respiratory Medicine, Kishiwada City Hospital, Osaka, Japan
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Sangani NK, Naliath SM. Tracheobronchopathia Osteochondroplastica as a Single Mass in Lingular Bronchus. Ann Thorac Surg 2018; 105:e83-e85. [DOI: 10.1016/j.athoracsur.2017.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/24/2017] [Accepted: 09/02/2017] [Indexed: 12/27/2022]
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Devaraja K, Sagar P, Chirom AS. Tracheobronchopathia osteochondroplastica: awareness is the key for diagnosis and management. BMJ Case Rep 2017; 2017:bcr-2017-220567. [PMID: 28784888 DOI: 10.1136/bcr-2017-220567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Tracheobronchopathia osteochondroplastica is a rare airway disease of unknown aetiology. Due to overlapping symptomology and lack of awareness, the condition is often missed resulting in unnecessary medical or surgical treatment. A male patient presented with a long-standing history of hoarseness and had earlier received treatment for bronchial asthma and tuberculosis. On evaluation, he had typical submucosal calcified nodules distributed throughout the trachea sparing the posterior membranous part. Although the biopsy confirmed the diagnosis of tracheobronchopathia osteochondroplastica in our case, histopathological examination is not always needed to make this diagnosis. Our patient has been kept under conservative management and is having non-progression of disease at 1-year follow-up. After having reviewed the literature related to pathophysiology and management of tracheobronchopathia osteochondroplastica, we emphasise on the fact that the treating physicians' awareness about this condition is the key to its diagnosis and management.
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Affiliation(s)
- K Devaraja
- Department of Otorhinolaryngology, Kasturba Medical College, Manipal, Karnataka, India
| | - Prem Sagar
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Amit Singh Chirom
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Abstract
Tracheobronchopathia osteochondroplastica (TO) is a relatively rare and benign disease of unknown etiology that is characterized by the accumulation of diffuse cartilaginous and osseous nodules protruding into the anterolateral walls of the trachea and bronchus. However, TO is easy to ignore or misdiagnose due to its nonspecific clinical manifestation. A chest computed tomography (CT) scan with a fiber bronchoscope and pathological biopsy shows the clinical features supporting the ultimate diagnosis.Here, we report 2 misdiagnosed cases of TO and review the literature to further define the diagnosis for clinicians. The first case was a 34-year-old male admitted to the hospital because of recurrent cough and intermittent fever for 10 years. CT scans showed irregular stenosis of the main bronchus and bronchofibroscope showed multiple nodules producing into the lumen. He was initially misdiagnosed of bronchial tuberculosis and received antitubercular agents for nearly half year. Symptoms got no relief and another bronchofibroscope with biopsy tests in our hospital exactly diagnosed of TO. Symptoms were significantly relieved after receiving budesonide associated with antibiotics, etc. Another case was a 46-year-old woman presenting with a history of repeated hoarseness for 8 years and a 2-month exacerbation. She underwent an electronic laryngoscopy 3 times and was diagnosed of laryngitis. Symptoms got no relief after antiinflammatory. CT scan indicated variable degrees of stenosis and calcification of the distal trachea and main bronchi and bronchofibroscope showed dozens of white nodules extruding into the lumen. Histopathologic findings revealed the ultimate diagnosis of TO and antiinflammatories, spasm relievers, and inhaled corticosteroids, showed apparent effects.Poor specificity of TO is observed in clinical manifestation and laboratory inspection. However, a CT scan associated with a bronchoscopy and histopathologic examination greatly contributes to a definitive diagnosis. No specific treatments are recommended, except treatments to alleviate symptoms. Thus, it is of great importance to consider TO when facing unsolved respiratory or external respiratory symptoms to improve the quality of life.
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Affiliation(s)
- Na Wang
- From the Department of Pulmonary Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
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Simmons C, Vinh D, Donovan DT, Ongkasuwan J. Tracheobronchopathia osteochondroplastica. Laryngoscope 2015; 126:2006-9. [PMID: 26667604 DOI: 10.1002/lary.25813] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2015] [Indexed: 12/29/2022]
Abstract
Tracheobronchopathia osteochondroplastica (TBOC) is a rare disease of the trachea and bronchi characterized by submucosal nodules of osseous and cartilaginous tissue. In this series, we present three cases highlighting the varied clinical presentations of this rare disease process, which ranged from a rough voice to a chronic cough to lobar pneumonia. The disorder may mimic other lesions. We review the clinical presentations, pathophysiology, lab tests, imaging, diagnosis, and management of TBOC patients. Laryngoscope, 126:2006-2009, 2016.
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Affiliation(s)
- Caleb Simmons
- Department of Otolaryngology-Head & Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Daniel Vinh
- School of Medicine, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Donald T Donovan
- Department of Otolaryngology-Head & Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Julina Ongkasuwan
- Department of Otolaryngology-Head & Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
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Sun J, Xie L, Su X, Zhang X. Tracheobronchopathia osteochondroplastica: Case report and literature review. Respir Med Case Rep 2015; 15:14-7. [PMID: 26236591 PMCID: PMC4501471 DOI: 10.1016/j.rmcr.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Tracheobronchopathia osteochondroplastica (TPO) is a rare disorder characterized as multiple osseous or cartilaginous nodules in the submucosa of trachea and main bronchi. TPO remains an under recognized entity due to lack of awareness. Four cases of TPO are reported in this review as well as various facets of TPO description.
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Affiliation(s)
- Junping Sun
- Department of Respiratory Medicine, Hainan Branch of People's Liberation Army General Hospital, Sanya 57200, China
| | - Lixin Xie
- Department of Respiratory Medicine, Hainan Branch of People's Liberation Army General Hospital, Sanya 57200, China
| | - Xianling Su
- Department of Respiratory Medicine, Hainan Branch of People's Liberation Army General Hospital, Sanya 57200, China
| | - Xingang Zhang
- Department of Respiratory Medicine, Hainan Branch of People's Liberation Army General Hospital, Sanya 57200, China
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Danckers M, Raad RA, Zamuco R, Pollack A, Rickert S, Caplan-Shaw C. A complication of tracheobronchopathia osteochondroplastica presenting as acute hypercapnic respiratory failure. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:45-9. [PMID: 25629203 PMCID: PMC4311905 DOI: 10.12659/ajcr.892427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/21/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tracheobronchopathia osteochondroplastica is a rare benign and often indolent disease. We report the first case of tracheobronchopathia osteochondroplastica (TBO) presenting as acute hypercarbic respiratory failure due to superimposed subglottic submucosal abscess. CASE REPORT A 27-year-old man presented to the emergency department in respiratory distress that required mechanical ventilation for acute hypercarbic respiratory failure. Upon extubation the next day, stridor was elicited with ambulation. Spirometry revealed fixed upper airway obstruction. Neck imaging showed a 2.8 × 2.0 × 4.0 cm partially calcified subglottic mass with cystic and solid component obstructing 75% of the airway. Surgical exploration revealed purulent drainage upon elevation of the thyroid isthmus and an anterolateral cricoid wall defect in communication with a subglottic submucosal cavity. Microbiology was negative for bacteria or fungi. Pathology showed chondro-osseous metaplasia compatible with tracheobronchopathia osteochondroplastica (TBO). The patient received a course of antibiotics and prophylactic tracheostomy. Since tracheostomy removal 3 days later, the patient remains asymptomatic. CONCLUSIONS Tracheobronchopathia osteochondroplastica is a rare disease with usually benign clinical course and incidental diagnosis. It may present as acute hypercarbic respiratory failure when subglottic infection is superimposed.
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Affiliation(s)
- Mauricio Danckers
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Medical Center, New York, NY, U.S.A
| | - Roy A. Raad
- Department of Radiology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Ronaldo Zamuco
- Department of Pathology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Aron Pollack
- Division of Otolaryngology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Scott Rickert
- Division of Otolaryngology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Caralee Caplan-Shaw
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Medical Center, New York, NY, U.S.A
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Warner MA, Chestnut DH, Thompson G, Bottcher M, Tobert D, Nofftz M. Tracheobronchopathia osteochondroplastica and difficult intubation: case report and perioperative recommendations for anesthesiologists. J Clin Anesth 2013; 25:659-61. [PMID: 23988800 DOI: 10.1016/j.jclinane.2013.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 05/22/2013] [Accepted: 05/26/2013] [Indexed: 12/15/2022]
Abstract
Tracheobronchopathia osteochondroplastica is a rare disorder characterized by cartilaginous or ossified submucosal nodules that project into the tracheobronchial lumen. It is typically discovered in the evaluation of chronic upper respiratory symptoms. A case of a completely asymptomatic man diagnosed with extensive disease throughout his upper airway after unanticipated difficult endotracheal intubation for elective surgery, is presented.
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Affiliation(s)
- Matthew A Warner
- Transitional Year Residency Program, Gundersen Health System, La Crosse, WI 54601, USA.
| | - David H Chestnut
- Department of Anesthesiology, Gundersen Health System, La Crosse, WI 54601, USA
| | - Gregory Thompson
- Department of Pulmonary and Critical Care Medicine, Gundersen Health System, La Crosse, WI 54601, USA
| | - Michael Bottcher
- Department of Anesthesiology, Gundersen Health System, La Crosse, WI 54601, USA
| | - Daren Tobert
- Department of Pulmonary and Critical Care Medicine, Gundersen Health System, La Crosse, WI 54601, USA
| | - Mary Nofftz
- Department of Anesthesiology, Gundersen Health System, La Crosse, WI 54601, USA
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