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tracheobronchomalacia
Etiology:
- see tracheomalacia
Pathology:
- softening of the tracheal & bronchial cartilage
- collapse of the airway during expiration [3]
Clinical manifestations:
- chronic cough
- chronic dyspnea
- wheezing may be heard over trachea
Special laboratory:
- dynamic collapse of airway during bronchoscopy (see pathology) [3]
- FEV1/FVC normal
Radiology:
- chest X-ray generally normal
- chest CT:
- may show collapse of trachea during expiration
Differential diagnosis:
- refractory asthma* reversible airway obstruction with bronchodilation
- tracheomalacia (pathology restricted to trachea)
- chronic bronchitis:
- no dynamic collapse of airway during bronchoscopy (FEV1/FVC may be normal)
- COPD: FEV1/FVC low (< 70% of predicted post bronchodiator)
* 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
tracheomalacia
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.
- Hammond K, Ghori UK, Musani AI.
Tracheobronchomalacia and Excessive Dynamic Airway Collapse.
Clin Chest Med. 2018 Mar;39(1):223-228.
PMID: 29433717 Review.