Extrinsic tracheotomy tube compression in a patient with upper airway obstruction: A case series

Tracheostomies are commonly performed procedures for a variety of indications, including to secure a patient’s airway when endotracheal intubation is not advisable. Though routine, tracheostomies are not possible without complications. We present the first reported cases of patients with idiopathic external compression of a tracheostomy tube following a tracheostomy. In both cases, standard algorithms for the management of tracheostomy tube occlusion were followed. In both patients, subsequent inability to reinsert the cannula prompted bedside bronchoscopy. The first patient demonstrated a 40% to 50% occlusion of the tracheostomy tube as a result of the tube itself being compressed externally. The occlusion did not resolve, despite change of the entire tracheostomy tube, until a tracheal ring was excised. The second patient had a bronchoscopy at the bedside, revealing a 20% compression of the tracheostomy tube that was managed conservatively. There are several complications that can arise when performing a tracheostomy, but no previous cases have been published describing external compression of the tracheostomy tube.