Tracheal Papilloma Mimicking Severe Asthma

Tracheal papillomatosis is a rare and challenging condition characterized by the development of benign tumors in the trachea and bronchial tree. This case report presents a 53-year-old female with refractory papillomatosis and mediastinal lymphadenopathy. Despite three previous resections, the papilloma recurred, causing moderate tracheal narrowing and symptoms mimicking severe persistent asthma. In June 2023, the patient underwent bronchoscopy with successful tumor debulking cryosurgery, significantly improving her symptoms.

The i-gel supraglottic airway device improves airway management during endobronchial ablative therapy under general anesthesia: a case report

Endobronchial ablative therapy (EAT) in patients with preexisting obstructive airway disease can cause hypoxemia because bronchoscope insertion interferes with ventilation and a low fraction of inspired oxygen (FiO₂) is essential to avoid airway fire. A man in his early 50s with moderately severe obstructive airway disease was scheduled for EAT for treatment of tracheal papillomatosis. Ventilation and oxygenation would have been difficult because of narrowing of the endotracheal tube by bronchoscopic insertion and a low FiO₂; therefore, an i-gel supraglottic airway device with a larger inner diameter was inserted. All visible intratracheal papillomas were ablated by a potassium titanyl phosphate laser through the bronchoscopic port that passed through the lumen of the i-gel at an FiO₂ of 0.3. During anesthesia for EAT, the i-gel supraglottic airway device provided a wider lumen for ventilation. We were thus able to provide stable ventilation at an FiO₂ of 0.3 during EAT in this patient with obstructive airway disease, avoiding airway fire and hypoxemia.