Case Reports of Acquired and Reversible Tracheomegaly

Dilation of the trachea, or tracheomegaly, is a rare phenomenon that can occur under a variety of disease processes and categorized into either congenital or acquired. In acquired cases, causes range from excessive tracheal wall pressure from prolonged intubation and cuff hyperinflation to inflammatory respiratory pathologies such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and cystic fibrosis. However, due to the low number of reported cases, the nature of these acquired processes is unclear. We present two cases that developed tracheomegaly of unknown etiology, one of which was reversible. Patients with factors predisposing them to tracheomalacia during intubation can experience significant air leaks with difficulty ventilating the patient and that could represent increasing tracheomegaly. Changing the cuff location intermittently during prolonged intubations may prevent tracheomegaly from occurring or may diminish its’ extent once it does occur. To the best of our knowledge, the reversibility of this relatively rare disorder has not been previously reported.