Tracheomalacia and Tracheobronchomalacia in Children and Adults

Carden, Kelly A.; Boiselle, Philip M; Waltz, David A.; Ernst, Armin

doi:10.1378/chest.127.3.984

Cited by 628 publications

(736 citation statements)

References 200 publications

(333 reference statements)

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“…However, shortness of breath, cough, sputum production, and other symptoms of obstruction and infection can be seen with the progression of the disease. The incidence of the disease has rapidly increased with the increased tracheomalacia awareness (8). While the asymptomatic cases can be followed without treatment, surgical techniques such as tracheal stents, tracheostomy tube implantation and external stabilization techniques can be used in certain cases with severe airway collapse (8)(9)(10)(11).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of the disease has rapidly increased with the increased tracheomalacia awareness (8). While the asymptomatic cases can be followed without treatment, surgical techniques such as tracheal stents, tracheostomy tube implantation and external stabilization techniques can be used in certain cases with severe airway collapse (8)(9)(10)(11). Previous publications have reported continuous positive airway pressure (CPAP) as the preferred method in treatment for tracheomalacia (8).…”

Section: Discussionmentioning

confidence: 99%

“…While the asymptomatic cases can be followed without treatment, surgical techniques such as tracheal stents, tracheostomy tube implantation and external stabilization techniques can be used in certain cases with severe airway collapse (8)(9)(10)(11). Previous publications have reported continuous positive airway pressure (CPAP) as the preferred method in treatment for tracheomalacia (8). In our first case, we treated the patient with a tracheal stent because of the life-threatening tracheal collapse and apnea which did not respond to bilevel positive airway pressure (BIPAP) with the suspicion of COPD.…”

Section: Discussionmentioning

confidence: 99%

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Two cases with tracheomalacia

Arısoy¹,

Yıldız²,

Bilgin³

et al. 2016

Respir Case Rep

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Tracheomalacia is a difficult to manage condition. The symptoms are similar to those of COPD and asthma patients. This may cause misdiagnosis. Herein, we present two tracheomalacia cases who received no benefit from inhaled treatment. The patients were examined via computed tomography (CT), bronchoscopy, and polysomnography. The first case was a 83-year-old male having a 50 package-year smoking history. He applied to the hospital due to coughing and followed for COPD. Obstructive sleep apnea was detected via polysomnography. Despite increased positive pressure, the apneas did not heal. On CT, tracheal flattening and tracheal ring and cartilages deterioration were detected. The patient had no sleep apnea one year after stenting. The second case was a 66-year-old male having inhaled treatment for five years for chronic coughing. In bronchoscopy, anterior and posterior parts of trachea were seen to cleave into each other in expiration. Since his tracheomalacia was not life-threatening, he has taken under follow-up. Key words: Apnea, cough, tracheomalacia, sleep.Tracheomalacia in adults is a severe disease which is very difficult to manage and treat. It causes frequent infections and mortality. Although there are no standardized techniques or criteria for the diagnosis of tracheomalacia, previously published articles recommend thoracic CT and bronchoscopy (1-3). The treatment approach is complex. There is no requirement in the treatment of mild asymptoTrakeomalazi yönetimi zor olan ciddi bir hastalıktır. Bu hastaların muayene bulguları KOAH ve astım hastalarına benzerdir. Bu nedenle tanıda yanılmaya sebep olabilir. Bu çalışmada, inhaler tedavilerden fayda görmeyen iki trakeomalazi olgusunu sunmayı amaçladık. Hastalar bilgisayarlı tomografi, bronkoskopi ve polisomnografi ile değerlendirildi. Birinci olgu 83 yaşında erkek hasta idi. Elli paket-yıl sigara anamnezi vardı. Hasta öksürük şikâyeti nedeni ile hastanelere başvurmuş ve 10 yıldır KOAH tanısıyla takip edilmişti. Polisomnografi ile uykuda obstrüktif apneleri tespit edildi. Arttırılan pozitif basınca rağmen apneleri düzelmedi. Bilgisayarlı tomografi ile trakeada yassılaşma, trakeal halka ve kıkırdaklarda bozulma tespit edildi. Trakeal stent takılan hastanın birinci yılın sonunda uyku apnesi yoktu. İkinci olgu beş yıl boyunca kronik öksürük nedeniyle farklı inhaler tedaviler verilen 66 yaşında bir erkek hastaydı. Hastanın öksürüğü sert ve gürültülü idi ve uyku apnesi yoktu. Bronkoskopide expiryumda trakeanın ön ve arka duvarının birbirine yapıştığı görüldü. Trakeomalazisi hayatı tehdit etmediğinden takibe alındı.Anahtar Sözcükler: Apne, trakeomalazi, öksürük, uyku. matic cases. The history for determining the etiology, physical analysis, radiological, and bronchoscopic examination are of utmost importance for the treatment (4). In this article, we evaluated the symptoms, diagnostic methods, and treatments of two patients who were admitted to our clinic for chronic cough and were diagnosed through computed tomography (CT) and bronchoscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Two cases with tracheomalacia

Arısoy¹,

Yıldız²,

Bilgin³

et al. 2016

Respir Case Rep

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“…In the event of upper airway obstruction fixed or variable extra-thoracic, a distinct change in the shape of the inspiratory/inspiratory ratios and curve can be observed, as compared to the normal. [3][4][5][6] There is also a change from the normal between the expiratory to inspiratory flow ratios. 4 Upper airway obstruction is relatively common in young children.…”

Section: Introductionmentioning

confidence: 99%

Forced inspiratory flow volume curve in healthy young children

Vilozni

Efrati

Barak

et al. 2009

Pediatric Pulmonology

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Summary. Introduction: Spirometry testing should include both expiratory and inspiratory measurements. Inspiratory forced maneuvers can demonstrate extrathoracic airway abnormalities, of which various symptoms may suggest asthma. However, the inspiratory portion of the forced flow/volume maneuver in young healthy children has not yet been described. Objectives: To document and analyze the forced inspiratory flow volume curve indices in healthy young children. Settings and Participants: Healthy preschool children (age 2.5-6.5 years) from community kindergartens around Israel. Methods: The teaching method included multi-target, interactive spirometry games and accessory games for inspiration (e.g., inspiratory whistle). Results: One hundred and fourteen out of a total of 157 children performed duplicate full adequate inspiratory maneuvers. Repeatability between two maneuvers was 5.6%, 4.0%, 5.1%, 7.3% for inspiratory capacity (IC), forced inspiratory vital capacity (FIVC), peak inspiratory flow (PIF), and mid inspiratory flow (FIF50). Inspiratory flow indices were significantly lower than the expiratory flow indices. The time to reach PIF was significantly longer (mean AE SD; 229 AE 21 msec) than the time to reach peak expiratory flow (92 AE 8 msec; P < 0.0001). The shape of the inspiratory curve was parabolic and did not vary with age. The formed predicted equations were in agreement with the extrapolated values for older healthy children. Conclusions: The majority of healthy young children can perform reliable maximum inspiratory flow volume curves. Our results provide a framework of reference equations for maximum inspiratory flow volume curve in the young children. The clinical applications of these equations have to be explored.

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“…TBM is a rare and serious complication in patients with various pulmonary conditions, including the following: long-term tracheal intubation, chronic obstructive pulmonary disease (COPD), smoking, chest trauma and lung surgery. [1][2][3][4] The aetiology and histopathological characteristics of TBM are unclear. The diagnostic criterion for TBM is a ⩾ 50% reduction in the CSA of the trachea with expiration compared with inspiration on CT scan and/or bronchoscopy.…”

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confidence: 99%