# Acquired Tracheomalacia Following Tracheostomy: A Case Report and Literature Review

## TL;DR

This case report describes a rare complication called acquired tracheomalacia following tracheostomy and highlights the effectiveness of conservative treatment with CPAP.

## Contribution

The paper presents a novel case of acquired tracheomalacia after tracheostomy and advocates for individualized conservative management strategies.

## Key findings

- Acquired tracheomalacia can occur as a late complication following tracheostomy.
- Conservative treatment with CPAP can be effective in managing tracheomalacia in selected cases.
- Timely endoscopic evaluation is crucial for diagnosis and management of post-tracheostomy airway complications.

## Abstract

Tracheostomy is a widely performed procedure to manage prolonged respiratory failure, but it is not without risk. One rare but serious late complication is acquired tracheomalacia, which can lead to airway collapse and respiratory distress. We report the case of an 82-year-old male patient diagnosed with acute inflammatory demyelinating polyneuropathy who underwent a tracheostomy after failed extubation. The procedure was uncomplicated, and the patient was successfully decannulated after a few months. However, he developed biphasic stridor two months following decannulation. Further evaluation revealed a focal collapse of the right lateral tracheal wall, consistent with tracheomalacia. Given the patient’s stable condition and localized collapse, a conservative management approach using continuous positive airway pressure (CPAP) was adopted, resulting in notable symptomatic improvement. This case highlights the importance of considering tracheomalacia in patients with prolonged intubation or challenging decannulation. Timely endoscopic evaluation is essential for diagnosis, and conservative measures like CPAP may be effective in selected cases, potentially avoiding the need for surgical intervention. The report emphasizes the need for clinical vigilance in the post-tracheostomy period and supports the role of individualized management strategies for late-onset airway complications.