Localized tracheomalacia as a complication of the Cole tracheal tube

The Cole tracheal tube is designed for use in neonates. Subglottic stenosis is a recognized complication of prolonged use of the tube. We report a case of tracheomalacia as a further complication of prolonged use of the tube. A 4-month-old infant with a history of repeated failed extubation and multiple medical problems was found to have an unusual region of severe inspiratory collapse localized to the upper 1 cm of the trachea. This was felt to be the result of pressure from the shoulder of the Cole tube which had been used for prolonged intubation. A tracheostomy was performed to bypass the collapse, but the infant subsequently died due to other medical problems.