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Case Reports
. 2025 Apr 1:14:372.
doi: 10.12688/f1000research.163217.1. eCollection 2025.

Case Report- Prevention strategies for permanent tracheostomy tube migration into the left main bronchus in tracheostomized patients

Said Khallikane  1   2 , Amine Bentahar  3   4 , Monsif Salek  3   4 , Ayoub Belhadj  1   2 , Younès Aissaoui  1   2
Affiliations
Case Reports

Case Report- Prevention strategies for permanent tracheostomy tube migration into the left main bronchus in tracheostomized patients

Said Khallikane et al. F1000Res. .

Abstract

Tracheostomy tube migration is a rare but potentially life-threatening complication. We present the case of a 66-year-old male with chronic obstructive pulmonary disease, dual-chamber pacemaker implantation for chronic ischemic cardiomyopathy, and supraglottic squamous cell carcinoma. The patient developed respiratory distress due to intrabronchial migration of the tracheostomy tube. Initial evaluation revealed significant respiratory effort, inspiratory stridor, and an absent tube at the stoma site. Imaging and bronchoscopy confirmed the tube's presence in the left main bronchus with associated mucosal inflammation. The patient underwent bronchoscopic-guided tube removal and successful repositioning of a cuffed tracheostomy tube under spontaneous ventilation anaesthesia. Following stabilization, he was discharged with plans for a permanent tracheostomy. Tracheostomy tube migration presents a significant diagnostic and therapeutic challenge, particularly given the scarcity of studies involving adults with this complication. This case highlights the importance of early recognition, prompt imaging-especially bronchoscopy-and tailored management strategies, while emphasizing the active involvement of the patient and family in the care pathway. It also underscores the necessity for vigilant monitoring to prevent severe, potentially fatal, complications.

Keywords: Tracheostomy tube migration; airway obstruction; bronchoscopy; respiratory distress; spontaneous ventilation anaesthesia.; supraglottic carcinoma.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Chest X-ray showing pacemaker position (blue arrow), lead Pathway (green/purple arrows), tracheal Deviation (red arrow), and Foreign Body (black arrow).
Figure 2.
Figure 2.. CT-Scan showing tracheostomy tube misplacement (green arrow), mediastinal shift, and pacemaker position (red arrow).
Figure 3.
Figure 3.. CT-Scan showing tracheostomy orifice (yellow arrow), misplaced Tube (green arrow), and vascular Calcifications (red/orange arrows).
Figure 4.
Figure 4.. Intraoperative placement of cuffed tracheostomy tube (A) using guidewire (B) for airway management.
Figure 5.
Figure 5.. Intraoperative tracheostomy tube placement with airway dilation and granulation tissue excision (A, B).
Figure 6.
Figure 6.. Extracted tracheostomy tube from left main bronchus showing discoloration and mucosal Debris.
See this image and copyright information in PMC

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References

    1. Cheung NH, Napolitano LM: Tracheostomy: Epidemiology, Indications, Timing, Technique, and Outcomes. Respir. Care. 2014;59(6):895–919. 10.4187/respcare.02971 - DOI - PubMed
    1. Parida P-K, Raja K, Alexander A, et al. : Factors Associated with Fracture and Migration of Tracheostomy Tube into Trachea in Children: A Case Series. PubMed. 2020;32(113):379–383. 10.22038/ijorl.2020.44797.2473 - DOI - PMC - PubMed
    1. Nyanzi DJ, Atwine D, Kamoga R, et al. : Tracheostomy-related indications, early complications and their predictors among patients in low resource settings: a prospective cohort study in the pre-COVID-19 era. BMC Surg. 2023;23(1):59. 10.1186/s12893-023-01960-5 - DOI - PMC - PubMed
    1. Murray M, Shen C, Massey B, et al. : Retrospective analysis of post-tracheostomy complications. Am. J. Otolaryngol. 2021;43(2):103350. 10.1016/j.amjoto.2021.103350 - DOI - PubMed
    1. Eskander A, Almeida JR, Irish JC: Acute Upper Airway Obstruction. N. Engl. J. Med. 2019;381(20):1940–1949. 10.1056/nejmra1811697 - DOI - PubMed

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