Tracheobronchomalacia vs Excessive Dynamic Airway Collapse

Persistent Notes

Highlights

  • intrathoracic, extratracheal pressure is greater than the intrathoracic intratracheal pressure p.123
  • approximately 30% physiologic reduction p.123
  • It consists of 2 distinct entities: tracheobronchomalacia (TBM) and excessive dynamic airway collapse p.123
  • widening of the coronal tracheobronchial dimension p.123
  • concomitant narrowing of the sagittal tracheobronchial dimension p.123
  • anterior bowing of the posterior membranous wall p.123
  • without deformation of the cartilaginous structure p.123
  • moderate when the cross-sectional area reduction is 80% to 89% p.123
  • severe when the cross-sectional area reduction is greater than or equal to 90% p.123
  • Tracheobronchomalacia (TBM) is a structural airway abnormality p.123
  • cartilaginous weakening of the trachea and bronchi p.123
  • Excessive dynamic airway collapse, on the other hand, is characterized by abnormal anterior bowing of the posterior membrane with a normal tracheal cartilage p.123
  • Awake dynamic bronchoscopy is the gold standard p.123
  • greater than or equal to70% p.123
  • dynamic computed tomography (CT) scan of the chest with expiratory and inspiratory phases and awake bronchoscopy p.124
  • When the geometry of the tracheobronchial cartilage is preserved throughout respiration p.124
  • EDAC p.124
  • when the airway is noted to be wider in the coronal dimension and narrower in the sagittal dimension p.124
  • normal C-shaped geometry of the tracheal bronchial cartilage is no longer visualized p.124
  • TBM p.124
  • 14.1% to 23.4% in patients with chronic cough p.124
  • up to 53% in patients with stable COPD p.124
  • causing atrophy of the tracheal or bronchial cartilages and fibers of the membranous portions p.124
  • airway stabilization and stenting p.124
  • bronchoscopic stenting versus routine bronchoscopic stenting p.124
  • tracheobronchoplasty p.124
  • Flow-volume loops from PFTs can demonstrate fixed as well as variable airway obstruction p.124
  • Variable airway obstruction can be extrathoracic or intrathoracic p.124
  • Both EDAC and TBM p.124
  • as variable p.124
  • TBM limits airflow and causes symptoms p.124
  • debate exists as to whether EDAC results in air flow limitation p.124
  • seal-like barky cough p.125

Reference

Lee S, Medina B, Lazzaro R. Tracheobronchomalacia vs Excessive Dynamic Airway Collapse. Thoracic Surgery Clinics. 2025;35(1):123-129. doi:10.1016/j.thorsurg.2024.09.002