gms | German Medical Science

Introduction: Defect closure with myocutaneous flaps in the upper aero digestive tract can be difficult and produce complications. We report about a patient with tracheal hair growth of a cutaneous flap after tracheotomy closure.

Method: A 55 year old patient, who was long term tracheotomy dependent after suffering from a polytrauma, presented years after cutaneous flap closure with a recurrence of dyspnoea and stridor. Multiple tracheobronchoscopies during recent years found ventral tracheal hair growth about 2 cm subglottic, which were physically epilated yearly for 4 years. A fractured cutaneous radiotherapy with a total dose of 40 Gy removed all endotracheal hair permanently.

Results: Plastical cutaneous flap closure procedures can lead to intra tracheal hair growth in rare occasions, which is a complication leading to slowly progressing dyspnoea and stridor and requires consecutive management. Multiple panendoscopies revealed recurrent ventral tracheal hair growth approximately 2 cm subglottic, which were physically epilated, only leading to a temporal solution. Radiotherapy with 40 Gy showed a permanent effect.

Conclusion: Tracheobronchoscopy and physical removal of tracheal hair only lead to a transient therapy success. Complications with hair in cutaneous flap closure procedures of the aero digestive tract can be dealt with radiotherapy and thus will lead to definite epilation.