[Osteochondroplastic tracheobronchopathy]

The words tracheobronchopathia osteochondroplastica (TO) were coined by Aschoff in 1910, defining a rare disease of the tracheobronchial system which most often is only "accidentally" discovered in the course of examinations, a bronchoscopy or computerized tomography, which are undertaken for other reasons. A characteristic sign for this disease are multiple cobblestone-like protrusions in the trachea and bronchus which are caused by calcifications, chondrifications and ossifications of the upper layer of the mucous membrane. We report on a 81-year old patient who was diagnosed with the disease while undergoing a fiberoptic bronchoscopy during a prolonged weaning phase. In the beginning we discussed the possibility of a neoplasia or a chronic inflammatory process as differential diagnosis and based on that we considered a dilatative tracheotomy for the weaning period. After histological confirmation of a TO we refrained from the measure, the reason being that in our opinion the patient would not profit from it. To reach a correct diagnosis a good interdisciplinarian cooperation is essential. The patient was successfully extubated on the 11th post-operative day after a patient conventional weaning which was supported by accompanying symptomatic measures. Apart from the case report we present a summary of the literature on TO concerning epidemiology, pathology, diagnosis and therapeutical measures.