Search
tracheomalacia
Etiology:
- prolonged endotracheal intubation (most common cause in adults)
Pathology:
- softening of the tracheal cartilage
- collapse of the airway during expiration when pathology is intrathoracic
Clinical manifestations:
- chronic cough
- chronic dyspnea
- wheezing best heard over trachea
Radiology:
- chest X-ray generally normal
- chest CT:
- may show collapse of trachea during expiration
Differential diagnosis:
- refractory asthma*
- tracheobronchomalacia
* ref [3] describes workup & diagnosis of patient origionally diagnosed with refractory asthma
Management:
- not responsive to glucocorticoids & bronchodilators
- symptomatic patients with multiple hospital admissions
- bronchoscopy with stent placement (first line)
- other surgery to prevent collapse of trachea
Related
tracheobronchomalacia
General
sign/symptom
References
- Stedman's Medical Dictionary 27th ed, Williams &
Wilkins, Baltimore, 1999.
- Carden KA, Boiselle PM, Waltz DA, Ernst A.
Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review.
Chest. 2005 Mar;127(3):984-1005.
PMID: 15764786 Review.
- Solomon DA, Fanta CH, Levy BD, Loscalzo J
Clinical problem-solving. Whistling in the dark
N Engl J Med. 2012 May 3;366(18):1725-30
PMID: 22551132
https://www.nejm.org/doi/10.1056/NEJMcps1106363