Laryngoscope Investigative Otolaryngology最新文献_第3页

Quality Improvement of Single-Institution Craniofacial Center Multidisciplinary Meetings Using Standardized Meeting Guides

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-14 DOI: 10.1002/lio2.70099

Aurelia S. Monk, Elexis Hollingsworth, Ezer H. Benaim, Lynn Fox, Lauren K. Leeper, Amelia F. Drake

Objectives

The American Cleft Palate Association-Craniofacial Association (ACPA-CPF) recommends regular multidisciplinary team meetings for comprehensive craniofacial patient care, yet standardized meeting guidelines are lacking. Lack of standardization may result in varying quality of care within and between institutions, as well as difficulty in creation of new multidisciplinary craniofacial teams at institutions without one. This study sought to assess craniofacial multidisciplinary team meetings and determine the utility of a meeting guidance tool in such meetings. It was set in a single institution's craniofacial center, and participants included multidisciplinary team members.

Methods

This project used the Plan-Do-Study-Act quality improvement method, completed in two phases. In the project's first phase, craniofacial team members assessed their current meetings with an evaluation instrument previously created. The evaluation results identified areas needing improvement, and a new meeting guide was created and implemented over four meetings. Team members also completed a survey comparing historical versus new meeting structures.

Results

Initial meeting quality was perceived positively, but evaluation with a standardized instrument revealed deficiencies, particularly in case presentation topics. Implementing a custom guide improved the provision of current and historical patient information and treatment plan summarization, although excessive repetition persisted. Adjustments to the custom meeting guide led to further quality enhancement, particularly in case presentation efficiency and meeting effectiveness.

Conclusion

Multidisciplinary team meetings are vital for comprehensive craniofacial care, but ensuring consistent quality is challenging. Our study demonstrates the value of utilizing standardized meeting guides to evaluate and create custom guides leading to quality improvement. Ongoing refinement is essential to address persisting issues and optimize patient outcomes.

Level of Evidence

5.

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引用次数: 0

A Century of Otorhinolaryngology at Yonsei University College of Medicine and Engagement With US Missionaries

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-10 DOI: 10.1002/lio2.70088

In Seok Moon, Min-Seok Rha, In-Sok Yeo, Chang-Hoon Kim

Objective

To provide a historical overview of the Department of Otorhinolaryngology at Yonsei University College of Medicine and highlight its contributions to the development of otorhinolaryngology in Korea.

Data Sources

Historical records of the Dongeun Medical Museum, Yonsei University College of Medicine, and related publications.

Review Methods

Historical review.

Results

Gwanghyewon, the first modern hospital established by American missionaries in Korea, later became the Severance Hospital (named after American philanthropist Louis Severance) and Yonsei University College of Medicine. The Department of Otorhinolaryngology at Yonsei University and Severance Hospital was established in 1908. Currently, the department has 24 professors and 6 clinical fellows specializing in otology, rhinology, and laryngology-head and neck surgery.

Conclusion

In the past 116 years, Yonsei Otorhinolaryngology has been devoted to the great clinical and academic development of otorhinolaryngology in Korea. The next century of Yonsei Otorhinolaryngology will build on the progress made in its legacy.

Level of Evidence

N/A.

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引用次数: 0

No-Shows in a Tertiary Care Pediatric Otolaryngology Clinic: Predictors and Impact on Provider Productivity 三级医疗机构儿科耳鼻喉科门诊中的无预约病例：预测因素及对医生工作效率的影响

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-08 DOI: 10.1002/lio2.70097

Yukta Sunkara, Seckin O. Ulualp, Kimberly Robinson, Felicity Lenes-Voit, Christopher C. Liu, Ron B. Mitchell

Objectives

No-show appointments (NS) lead to a mismatch between supply and expected demand, operational inefficiency, decreased access to care, and economic deficit. We evaluated the predictors and impact of NS on provider productivity in a tertiary pediatric otolaryngology clinic.

Methods

Patients who had a pediatric otolaryngology clinic appointment were identified. Demographics, type of appointment and clinic visit, provider, insurance, appointment lead time, time of the appointment, caregiver income, distance to the clinic, and season of the year were analyzed. Predictors of NS and loss of providers' work-RVUs and revenue were assessed. NS and non-NS populations were compared using χ² test for categorical variables and Mann–Whitney test for continuous variables. Multivariable analysis was performed with a binary logistics regression model for the prediction of NS.

Results

Of 24,593 appointments, 10,392 (42%) were female, (age median = 5 years) and of the 4627 NS 2016 (44%) were female, (age median = 5 years). Logistic regression identified male (OR: 0.093, 95% CI [0.88–0.99], p = 0.04), Black/African American race (OR: 1.97, 95% CI [1.72–2.26], p < 0.001), spring (OR: 0.88, 95% CI [0.80–0.97], p = 0.007), summer (OR: 0.90, 95% CI [0.83–0.99], p = 0.04), clinic focus-general clinic (OR: 1.32, 95% CI [1.20–1.45], p < 0.001), and appointment lead times of 0–7 days (OR: 0.36, 95% CI [0.29–0.46], p < 0.001), 8–14 days (OR: 0.49, 95% CI [0.39–0.63], p < 0.001), 15–30 days (OR: 0.60, 95% CI [0.47–0.76], p < 0.001) were predictive of NS. The estimated loss of work-RVU ranged from 3852 to 14,820, and the estimated loss of revenue ranged from $276,831 to $959,908 per year.

Conclusions

No-show appointments led to a substantial loss of provider productivity and revenue. Of the multiple demographic and clinic visit determinants associated with high NS rates, appointment lead time can be tested in future studies of strategies to reduce NS.

Level of Evidence

4

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引用次数: 0

A Novel Hybrid Solution for Hearing Impairments

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-08 DOI: 10.1002/lio2.70089

Hassan Alshehri, Medhat Yousef, Anas Ibrahim, Yassin Abdelsamad, Farid Alzhrani

Objective

Conventional hearing aids (HAs) and bone conduction devices have limitations in providing clear and audible sound in some cases and situations. The clinicians' primary purpose is to enhance audibility and intelligibility in hearing, offering a solution for users dissatisfied with current hearing technologies. This study proposes a novel hybrid system and investigates its performance compared to HAs.

Methods

This pilot study compares the performance of a novel hybrid system with traditional HAs. Ten HA users underwent a prospective intra-subject study at a tertiary hearing center. Audiological tests measured unaided and aided thresholds across specific frequencies in two conditions (HAs and Hybrid system). Furthermore, subjective outcomes were assessed via a questionnaire on the perceptual consequences.

Results

The patient's mean age was 36 years. The mean PTA4 values were 63.75, 40.74-, and 37.88-dB HL in the unaided, HA-aided, and Hybrid-aided groups, respectively. The speech reception thresholds varied significantly between the unaided and (i) aided using HA (p = 0.0009) and (ii) aided using the Hybrid solution (p = 0.0001). There is no significant variation between HA and Hybrid solutions (p < 0.4195). The mean SDS at 65 dB using the HA and Hybrid solution was 87% and 90%, respectively.

Conclusion

The proposed Hybrid system, combining conventional air-conduction HAs with bone-conduction devices, offers promising improvements in sound quality and user satisfaction. Further studies are essential to fully understand the Hybrid system's capabilities and evaluate its ability to avoid the dissatisfaction that could result from HA in some instances.

Level of Evidence

Prospective cohort study (Level 3).

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引用次数: 0

A Novel Effect of Allium tuncelianum Extract: Topical Application Improves Wound Healing in a Nasal Septal Perforation Rat Model

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-08 DOI: 10.1002/lio2.70095

Doğan Çakan, Zeliha Kübra Çakan, Gülderen Yılmaz, David Yeung, Gülnur Ekşi Bona

Objective

The objective of the current study was to investigate the influence of Allium tuncelianum (AT) extract on wound healing in a nasal septum perforation (NSP) model.

Methods

Twenty-two healthy male Sprague–Dawley rats were included in this study and separated into two groups. A standardized NSP was created in each subject. A 0.09% saline (control group) and the 25% AT solution (study group) were delivered intranasally daily for 14 days. At the end of the experiment, the subjects were sacrificed and the septa were excised for histopathological investigation. The macroscopic closure rate of NSP, intranasal pH, counts of acute inflammatory cells, eosinophil, fibroblast, and giant cell, epithelial regeneration and degeneration, vascularization, granulation formation, collagen density, cartilage regeneration, and degeneration were examined. The obtained data were analyzed statistically.

Results

The macroscopic closure rate (p = 0.006), the fibroblast number (p = 0.003), vascularization (p = 0.003), collagen density (p = 0.044), and granulation tissue amount (p = 0.022) were found to be significantly higher in AT group. However, the acute inflammatory cells count was significantly lower in AT group (p = 0.031) (p < 0.05).

Conclusion

The topically delivered AT extract may improve wound healing in an experimental NSP model. Consequently, the local application of AT might be promising to prevent the formation of NSP.

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引用次数: 0

Respiratory-Swallow Coordination of Uncued Swallows in Dysphagic and Tracheotomized Patients

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-08 DOI: 10.1002/lio2.70098

Martin Gerbert, Veronika Segler, Julia Adam, Arneborg Ernst, Benjamin Riebold, Philipp Mittmann, Rainer Seidl

Objective

The aim of this study was to evaluate the respiratory-swallow coordination (RSC) in healthy, dysphagic, and subjects with blocked, unblocked or without tracheostomy cannula (TC) over 2 h with focus on unintended deglutition.

Methods

In a single center (cross-sectional) observational study, a total of 65 subjects were included. Swallowing processes were recorded using RehaIngest (Hasomed GmbH, Magdeburg, Germany), combining electromyography (EMG) and bioimpedance (BI) inputs. Group differences were calculated using non-parametric tests, the influences of age and gender were evaluated using regression analysis.

Results

Respiratory patterns from 3761 swallows were evaluated. Nineteen healthy and 46 dysphagic subjects, including 15 without TC, 15 with blocked TC and 16 with unblocked TC, were recorded. In the dysphagia cohort unblocked and without TC demonstrated increased post-deglutitive expiration (p = 0.012, p = 0.001) and a decrease in post-deglutitive inspiration (p = 0.028, p = 0.013) compared with healthy probands. In addition, a higher proportion of subjects demonstrating post-deglutitive expiration was recorded amongst probands with unblocked TC compared to blocked TC (p = 0.012). Neither age nor gender significantly impacted the aforementioned outcomes.

Conclusion

Our novel cross-sectional study shows that the RSC adapts in a compensatory fashion in the acquired dysphagia cohort. The adaptation depends on the occurrence of dysphagia and the type of TC. If the TC cuff is blocked, patients likely have an inadequate adaptation of the RSC, mainly because of the absence of a transglottic air flow. These findings indicate that RSC and TC care should be closely incorporated into clinical routine to improve dysphagia therapy.

Level of Evidence

1

{"title":"Respiratory-Swallow Coordination of Uncued Swallows in Dysphagic and Tracheotomized Patients","authors":"Martin Gerbert, Veronika Segler, Julia Adam, Arneborg Ernst, Benjamin Riebold, Philipp Mittmann, Rainer Seidl","doi":"10.1002/lio2.70098","DOIUrl":"https://doi.org/10.1002/lio2.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the respiratory-swallow coordination (RSC) in healthy, dysphagic, and subjects with blocked, unblocked or without tracheostomy cannula (TC) over 2 h with focus on unintended deglutition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a single center (cross-sectional) observational study, a total of 65 subjects were included. Swallowing processes were recorded using RehaIngest (Hasomed GmbH, Magdeburg, Germany), combining electromyography (EMG) and bioimpedance (BI) inputs. Group differences were calculated using non-parametric tests, the influences of age and gender were evaluated using regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Respiratory patterns from 3761 swallows were evaluated. Nineteen healthy and 46 dysphagic subjects, including 15 without TC, 15 with blocked TC and 16 with unblocked TC, were recorded. In the dysphagia cohort unblocked and without TC demonstrated increased post-deglutitive expiration (<i>p</i> = 0.012, <i>p</i> = 0.001) and a decrease in post-deglutitive inspiration (<i>p</i> = 0.028, <i>p</i> = 0.013) compared with healthy probands. In addition, a higher proportion of subjects demonstrating post-deglutitive expiration was recorded amongst probands with unblocked TC compared to blocked TC (<i>p</i> = 0.012). Neither age nor gender significantly impacted the aforementioned outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our novel cross-sectional study shows that the RSC adapts in a compensatory fashion in the acquired dysphagia cohort. The adaptation depends on the occurrence of dysphagia and the type of TC. If the TC cuff is blocked, patients likely have an inadequate adaptation of the RSC, mainly because of the absence of a transglottic air flow. These findings indicate that RSC and TC care should be closely incorporated into clinical routine to improve dysphagia therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>1</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A comprehensive analysis of MRI-related Cochlear implant adverse events reported by FDA's manufacturer and user facility device experience database

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-06 DOI: 10.1002/lio2.70073

Amy Lin BS, Arjun K. Menta BSA, BBA, Syed Ameen Ahmad BS, Aileen Zhang BA, Dianela Perdomo BS, Ashwin Reddy BS, Bryan K. Ward MD

Objective

Identify MRI-related cochlear implant (CI) adverse events from the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database and determine whether devices with diametric magnets are associated with reduced adverse events.

Methods

Data on MRI-related adverse events were collected from the MAUDE database for reports filed between 01/01/2013 and 01/29/2023. Outcomes and interventions were manually extracted. Device problems, electrode designs, and correlated patient problems were grouped and analyzed using R.

Results

All CI complications were derived from three manufacturers: Cochlear Limited, Advanced Bionics, and MED-EL. MRI-related CI complications occurred in 668 of 32,446 reports (2.1%). MRI-related CI complications increased from 32 reports (4.8%) in 2013 to a peak of 142 reports (21.3%) in 2019 and decreased to 56 reports (8.4%) in 2022. The most common MRI-related device problems were dislodgment/dislocation (39.9%, n = 266) or migration/expulsion (33.4%, n = 223). The most frequently identified patient problems identified were pain (31.6%, n = 211), hearing impairment (4.9%, n = 33), unspecified medical problems (3.7%, n = 25), implant failure (3.0%, n = 20), and injury (1.5%, n = 10). Of these, 358 reports (53.6%) contained the date of device manufacture. The median MDR per year decreased from 11 in the 3 years before each manufacturer released their MRI-conditional CI to 0 in the 3 years following the release (p = 0.014).

Conclusions

The introduction of MRI-conditional CIs has successfully reduced MRI-associated adverse events. There have been no reported cases of MRI-related CI complications for devices containing the new MRI-conditional magnets for each of the three major US manufacturers.

Level of evidence

N/A

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引用次数: 0

Development of a Clinical Prediction Model to Predict Malignant Transformation of Sinonasal Inverted Papilloma Based on Hematological Indices and Clinical Features

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-06 DOI: 10.1002/lio2.70075

Kai Sun, Ce Wu, Zengxiao Zhang, Jiahong Chen, Xudong Yan, Shunke Li, Lin Wang, Longgang Yu, Yan Jiang

Objective

Sinonasal inverted papilloma (SNIP) has a risk of malignant transformation into SNIP with squamous cell carcinoma (SNIP-SCC). Early detection of SNIP-SCC is crucial for patient outcomes. This study aimed to evaluate the utility of tumor-related hematological indices in the early diagnosis of SNIP-SCC and to develop a nomogram incorporating imaging and clinical features.

Methods

This study included 159 patients with SNIP with (n = 34) or without (n = 125) SCC. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors and develop nomogram. The diagnostic model was evaluated using receiver operating characteristics (ROC), standard, clinical decision, and clinical impact curves.

Results

Elevated serum cytokeratin fragment antigen 21-1 (CYFRA 21-1), the loss of convoluted cerebriform pattern, bone destruction, headache/facial pain, and epistaxis/blood-tinged mucus were identified as independent risk factors for SNIP-SCC. The optimal cut-off value for serum CYFRA 21-1 was 3.51 ng/mL, with the nomogram area under the ROC curve of 0.966 based on the above indicators.

Conclusion

The findings suggest that CYFRA 21-1 is a promising diagnostic marker for SNIP-SCC. The nomogram incorporating serum CYFRA 21-1, imaging features, and clinical factors demonstrates strong clinical utility and can be a reference tool for clinical decision-making.

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引用次数: 0

Multiple Mutations—A Genetic Marker for Extracapsular Spread in Human Papillomavirus/p16-Positive Oropharyngeal Carcinoma

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-04 DOI: 10.1002/lio2.70094

Raphaela Graessle, Iris Piwonski, Cora Husemann, Karsten Kleo, Deema Sabtan, Achim Franzen, Heidi Olze, Ulrike Erben, Michael Hummel, Annekatrin Coordes

Background

In the 8th edition of the TNM classification, extracapsular spread (ECS) became a factor in classifying the UICC stage of oropharyngeal carcinomas (OPSCC). We aimed to find genetic markers for ECS and to identify differences between HPV/p16-positive and HPV/p16-negative cases.

Methods

We performed targeted next-generation sequencing on 99 samples of operable OPSCC and a retrospective analysis of clinical data.

Results

We included 55 HPV/p16-positive and 44 HPV/p16-negative patients. We found a significant difference between both groups, particularly in TP53 mutation (p < 0.001). Among other things, a small primary tumor (p < 0.001), no ECS (p = 0.026) were identified as predictors for survival. Multiple mutations were associated with an increased incidence of ECS, especially in HPV+/p16+ cases (p = 0.017). A mutation in PIK3CA occurred more frequently in nonsmokers, especially in HPV−/p16− patients (p = 0.027). A PTEN mutation—which only occurred in HPV+/p16+ tissues—reduced disease-free survival (DFS, p = 0.026).

Conclusion

The presence of multiple mutations in HPV+/p16+ OPSCC was associated with a higher risk of ECS.

Level of Evidence

3

{"title":"Multiple Mutations—A Genetic Marker for Extracapsular Spread in Human Papillomavirus/p16-Positive Oropharyngeal Carcinoma","authors":"Raphaela Graessle, Iris Piwonski, Cora Husemann, Karsten Kleo, Deema Sabtan, Achim Franzen, Heidi Olze, Ulrike Erben, Michael Hummel, Annekatrin Coordes","doi":"10.1002/lio2.70094","DOIUrl":"https://doi.org/10.1002/lio2.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the 8th edition of the TNM classification, extracapsular spread (ECS) became a factor in classifying the UICC stage of oropharyngeal carcinomas (OPSCC). We aimed to find genetic markers for ECS and to identify differences between HPV/p16-positive and HPV/p16-negative cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed targeted next-generation sequencing on 99 samples of operable OPSCC and a retrospective analysis of clinical data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 55 HPV/p16-positive and 44 HPV/p16-negative patients. We found a significant difference between both groups, particularly in TP53 mutation (<i>p</i> < 0.001). Among other things, a small primary tumor (<i>p</i> < 0.001), no ECS (<i>p</i> = 0.026) were identified as predictors for survival. Multiple mutations were associated with an increased incidence of ECS, especially in HPV+/p16+ cases (<i>p</i> = 0.017). A mutation in PIK3CA occurred more frequently in nonsmokers, especially in HPV−/p16− patients (<i>p</i> = 0.027). A PTEN mutation—which only occurred in HPV+/p16+ tissues—reduced disease-free survival (DFS, <i>p</i> = 0.026).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The presence of multiple mutations in HPV+/p16+ OPSCC was associated with a higher risk of ECS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

First Case of Tracheobronchopathia Osteochondroplastica in an 82-Year-Old Patient From Saudi Arabia

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-02-04 DOI: 10.1002/lio2.70093

Mohammed Hady Albitar, Nida Mariyam, Seba Albitar, Reem Warrar, Anas Sultan, Sarmad Chaudhry, Abdullah AlMahmoud

Background

Tracheobronchopathia osteochondroplastica (TPO) is a benign tracheobronchial disorder characterized by the presence of osseous or cartilaginous nodules, typically affecting the proximal large airways while sparing the posterior membranous trachea. Around 600 cases has been documented worldwide for this rare disorder. While most cases are asymptomatic, some patients may exhibit symptoms such as dyspnea and chronic cough. These symptoms could be attributed to either the ulceration of the nodules or the onset of an acute infection. As it is a vague and rare disease, TPO goes undiagnosed in most cases.

Case Description

This case represents an 82-year-old male with ischemic cardiomyopathy and a history of colon cancer who presented with a six-month history of mild hemoptysis, occasional cough, and wheezing. Laboratory tests were normal except for a positive PPD test. Imaging showed tracheal thickening with nodularity and calcification, and bronchoscopy confirmed the diagnosis. The patient was managed with symptomatic treatment and close follow-up. Over 2 years, he remained stable, experiencing only two self-limiting hemoptysis episodes with resolution of other symptoms.

Conclusion

This is the first case of TPO reported in Saudi Arabia. Given its nonspecific presentation, clinicians consider TPO as a differential diagnosis for patients with recurrent respiratory symptoms that do not respond to standard medical treatment.

Level of Evidence

4.

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引用次数: 0