Tracheobronchopathia osteoplastica: cause of difficult tracheal intubation

Tracheobronchopathia osteochondroplastica is a rare benign disorder affecting the trachea and the bronchi. We report a case presenting as difficulty during tracheal intubation. Chest roentgenogram revealed nothing before surgery. Findings on computed tomographic imaging scans show calcified nodular densities protruding into the tracheal lumen, with an abnormally irregular tracheal morphology and decreased lateral diameter. The fiber optic bronchoscopy, which was unable to pass more than 4 to 5 cm, showed enormous prominent protrusion with significant narrowing of the tracheal lumen. The diagnosis was confirmed by virtual bronchoscopy, which showed a tracheal narrowing with a beaded appearance and an irregular border that extended into the trachea and main bronchi.