Rare visual diagnosis in cases of chronic coughing

Introduction ENT specialists are often consulted in cases of chronic coughing. Our report relates to a very rare cause of this with very characteristic endoscopy findings.

Tracheobronchopathia osteochondroplastica is a rare but benign disease of unknown aetiology with multiple submucosal osteocartilaginous nodules that extend into the lumen of the respiratory tract. Patients may not experience any symptoms but may also suffer from exertional dyspnoea, respiratory sounds, frequent infections or even haemoptysis. The disease normally progresses slowly.

Materials and methods Individual case study of a 60-year-old patient who had been suffering from a sustained irritation of the throat for around 8 months with a parasternal foreign body sensation. There was only a small amount of expectoration, no general worsening of the condition, negative allergy history, only occasional smoking but not on an everyday basis. The transnasal video laryngostroboscopy did not yield any remarkable findings. After topical anaesthesia of the larynx, the trachea was also investigated. This showed non-irritated mucosa but multiple nodular areas of swelling in the area of the tracheal rings only, not between the rings and not on the pars membranacea.

Images of the trachea obtained with the laryngoscope are presented.

Discussion In the subsequent presentation to respiratory specialists, the images of the findings obtained by the ENT doctors were able to be used to make the very rare diagnosis on the basis of the typical morphology. A bronchoscopy was not required. The diagnosis is benign and there are no therapeutic options.

The case is encouraging for expanding flexible laryngoscopy to use tracheoscopy and demonstrates the advantages of video endoscopy in interdisciplinary patient care.

Poster-PDF A-1666.pdf

Publication History

Article published online:
07 August 2020