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Clinical Note
Jan 2012

Tracheal Obstruction Due to Heterotopic Ossification in a Tracheostomy Scar

Author Affiliations

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Dr Ilan) and Pathology (Dr Prus), Hadassah-Hebrew University Medical Center, and Chronic Ventilation Unit, Herzog Hospital (Drs Zamsky and Marcus), Jerusalem, Israel.

Arch Otolaryngol Head Neck Surg. 2012;138(1):76-78. doi:10.1001/archoto.2011.213

Long-term tracheostomy has been associated with various complications, including obstruction of the distal end of the tube by granulation tissue in the trachea, stenosis of the stoma, dilatation of the stoma, tracheomalacia, tracheal stenosis, tracheoinnominate artery fistula, and tracheoesophageal fistula.1,2 We report a rare and, to our knowledge, previously undescribed life-threatening complication resulting from tracheal obstruction due to heterotopic ossification in a tracheostomy scar in a mechanically ventilated patient. The ossification prevented intubation or the insertion of a larger tracheostomy tube. Unlike heterotopic ossification in abdominal scars, which is benign, ossification in a tracheostomy scar may be life-threatening during a routine change of a tracheostomy tube. With the increasing number of tracheostomies performed in long-term ventilated patients, physicians may encounter this complication and should be aware of its presentation, management, and possible prevention.

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