[Type I hypersensitivity to a silicone tube after laryngectomy]

While irritation of the tracheal mucosa is a common finding after laryngectomy, specific hypersensitivity to tracheal tubes or their components is extremely rare and has only been documented as a contact allergy. In this case report, we present type I hypersensitivity to tracheal tube components for the first time. The patient regularly used a special silicone tube for swimming after laryngectomy and complained about increasing tracheal irritation during and after the use of this tube. A standard skin prick test with common aeroallergens and a skin patch test with standard, rubber and adhesive allergens as well as with parts of the silicone tube was performed. Different parts of the tracheal tube were also tested with a scratch test. Total IgE as well as specific IgE for latex allergens was measured. Both skin prick and patch tests were negative. No specific IgE for latex allergens was detected. The scratch test generated strongly positive reactions against native tube material. The positive findings in the skin tests demonstrate specific hypersensitivity to the tracheal tube or its components in terms of a type I hypersensitivity. The causative component remains unclear.