Tracheaobronchomalacia

Tracheobronchomalacia is a rare condition where the tracheal (windpipe) cartilage is soft. Similar to tracheomalacia, tracheobronchomalacia affects the mainstem bronchi, the tubes that carry air to the lungs. When the tracheal cartilage softens, breathing becomes difficult.

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Symptoms

Symptoms of tracheobronchomalacia include:

  • Wheezing when exhaling and a high-pitched noise when inhaling.
  • Respiratory distress and difficulty breathing.
  • Coughing.
  • Inability to clear excretions and mucous.
  • Repeated upper respiratory infections.
  • A bluish color to the skin surrounding the mucous membranes of the nose and mouth.

Causes and Risk Factors

Tracheobronchomalacia in children is thought to be congenital (hereditary). In adults, the risk factors are being an older male smoker, often with chronic obstructive pulmonary disease (COPD). Other causes of tracheobronchomalacia are:

  • Damage to the trachea due to a tracheostomy, where an incision is made into the windpipe and a tube is inserted to assist in breathing.
  • Tracheal fractures.
  • Compression of the trachea due to tumors or masses.
  • Thyroid tumors.
  • Dilated aortic or pulmonary arteries.
  • Chronic irritation due to coughing, as from asthma.
  • Second hand smoke.
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Diagnosis

Your physician may order one or more of the following tests to confirm a diagnosis of tracheobronchomalacia:

  • A pulmonary function test such as spirometry, to see how the air moves in and out of your lungs
  • An exercise test such as walking to measure breathing capacity.
  • An X-ray of the chest and trachea.
  • A dynamic 3-D computed tomography (CT) scan of the neck and chest.
  • Endoscopic examination of the larynx, bronchi and trachea.
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Treatments

The physicians at the Women's Guild Lung Institute are experts at treating tracheobronchomalacia. The treatment almost always involves some sort of surgery to fully correct the collapse of the trachea. The technique chosen by you and your doctors may include stenting or resection (reconstruction) of the trachea.

With stenting, a silicone tube is surgically inserted into your trachea to open the airway. If the stenting is successful, your surgeon may recommend a mesh stent be permanently and surgically inserted and attached (tracheobronchoplasty).

Reconstruction of the trachea is an option when only a small portion of the trachea is involved. The surgeon removes the damaged portion, joining the remaining ends.