TRACHEOBRONCHOMALACIA AND HYPERDYNAMIC AIRWAY COLLAPSE

Abstract

Tracheobronchomalacia (TBM) and hyperdynamic airway collapse (HDAC) are similar in presentation but differ in anatomy affected. These two entities refer to the loss of structural integrity of the airway walls. The prevalenceof TBM and HDAC is not known. Diagnoses associated with TBM and HDAC include gastroesophageal reflux disease, chronic infections, emphysema, prior surgical manipulation of the trachea, sleep apnea, and collagen vascular diseases. Diagnostic testing includes computed tomographic (CT) scan of the chest with dynamic expiratory imaging, pulmonary function testing, six minute walk test, impedance probe for reflux disease, and a bronchoscopy for airway exam. If sleep apnea is suspected a polysomnogram should be pursued. If the inciting disease process can be identified, it should be aggressively treated. Weight loss is a critical aspect of the management of TBM and HDAC. Placement of a silicone stent into the airway may solidify the diagnosis and determine which patients will be successful with trachebronchoplasty.