日気食会報，73（1），2022A Case of Paratracheal Diverticulum Thought to be a Late Complication Caused by a Tracheostomy Performed 20 Years EarlierJ. Jpn. Bronchoesophagol. Soc., 73 : 36─42, 2022We report a case of paratracheal air cyst that was thought to be a late complication caused by a tracheostomy performed 20 years earlier. The patient was a 71-year-old man who had under-gone a tracheostomy as part of treatment for aortic dissection. After the tracheostomy stoma was closed, he showed no symptoms until 20 years later, when he experienced swelling and anterior neck pain accompanying an upper airway infection. Although the pain was subsequently relieved, the swelling remained. Initially a doctor belonging to a different department detected a cystic le-sion in the anterior region of the trachea by CT scan examination, and the patient was referred to our ENT department. After conservative treatment proved ineffective, we performed a cystecto-my. Postoperative pathology suggested that there were 2 emphysemas, each of a different histo-logical structure. One had findings consistent with a tracheal diverticulum and the other had the findings of a simple cyst. Based on the pathological findings and a literature review, we postulated that the tracheal lumen mucosa had deviated from an insufficiently closed tracheostomy wound, a tracheal diverticulum had formed, and an upper airway infection caused a tracheal air leak around the diverticulum which caused pseudocysts to form. Although there have been no previous re-ports of tracheal diverticulum related to an earlier tracheostomy, we presumed that other tracheal diverticula cases might exist but did not show as a result of the postoperative healing process. We concluded that if there is a patient with a history of tracheostomy who shows any symptoms, we should undertake close examination of a cervical-chest CT image and check for the presence of a tracheal diverticulum.Key words : tracheostomy, late complication, paratracheal air cyst, tracheal diverticula421）Department of Otolaryngology, Kawasaki Municipal Ida Hospital, Kanagawa, 4）Department of Otolaryngology, Keio University School of Medicine, Tokyo2）Department of Otolaryngology, Keiyu Hospital, Kanagawa, 3）Department of Otorhinolaryngology-Head & Neck Surgery, Japanese Red Cross Ashikaga Hospital, Tochigi, and Ikue Konoeda, M.D.1）, 2）, Shun-ichi Sasaki, M.D.3）, and Kaoru Ogawa, M.D., Ph.D.4）
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