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Chest
Diagnosis
Airway Diseases
Airway Narrowing and Wall Thickening
Tracheobronchomalacia
Tracheobronchomalacia
Aletta Ann Frazier, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Tracheomalacia, bronchomalacia

            • Definitions

              • Increased compliance and excessive collapsibility of trachea &/or bronchi

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • MR Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Dubey S et al: Respiratory subtype of relapsing polychondritis frequently presents as difficult asthma: a descriptive study of respiratory involvement in relapsing polychondritis with 13 patients from a single UK centre. ERJ Open Res. 7(1), 2021
                                      2. Lima E et al: What is the optimal large airway size reduction value to determine malacia: exploratory bronchoscopic analysis in patients in Mounier-Kuhn syndrome. J Thorac Dis. 13(1):5-429, 2021
                                      3. Hysinger EB et al: Ultrashort echo-time MRI for the assessment of tracheomalacia in neonates. Chest. 157(3):595-602, 2020
                                      4. Mittal A et al: Chronic vaping related tracheomalacia (TM): a case of vaping induced altered innate immunity that culminated in severe TM. Cureus. 12(4):e7571, 2020
                                      5. Muthialu N et al: Management of tracheal diseases in children. Front Pediatr. 8:297, 2020
                                      6. Ren W et al: Prolonged endotracheal intubation: a feasible option for tracheomalacia after retrosternal goitre surgery. Ann Palliat Med. 9(4):1764-9, 2020
                                      7. Les AS et al: 3D-printed, externally-implanted, bioresorbable airway splints for severe tracheobronchomalacia. Laryngoscope. 129(8):1763-71, 2019
                                      8. Wallis C et al: ERS statement on tracheomalacia and bronchomalacia in children. Eur Respir J. 54(3), 2019
                                      9. Kheir F et al: Tracheobronchomalacia and excessive dynamic airway collapse: medical and surgical treatment. Semin Respir Crit Care Med. 39(6):667-73, 2018
                                      10. McInnis MC et al: Advanced technologies for imaging and visualization of the tracheobronchial tree: from computed tomography and MRI to virtual endoscopy. Thorac Surg Clin. 28(2):127-37, 2018
                                      11. Shepard JO et al: Imaging of the trachea. Ann Cardiothorac Surg. 7(2):197-209, 2018
                                      12. Buitrago DH et al: Current concepts in severe adult tracheobronchomalacia: evaluation and treatment. J Thorac Dis. 9(1):E57-66, 2017
                                      13. Burke AP et al: Diseases of the trachea and bronchi practical thoracic pathology. In Diseases of the Lung, Heart and Thymus. Wolters Kluwer. 47-154, 2017
                                      14. Luo M et al: Diagnostic Value of multidetector CT and its multiplanar reformation, volume rendering and virtual bronchoscopy postprocessing techniques for primary trachea and main bronchus tumors. PLoS One. 10(9):e0137329, 2015
                                      15. Ridge CA et al: Tracheobronchomalacia: current concepts and controversies. J Thorac Imaging. 26(4):278-89, 2011
                                      16. Gaissert HA et al: The compromised airway: tumors, strictures, and tracheomalacia. Surg Clin North Am. 90(5):1065-89, 2010
                                      17. Javidan-Nejad C: MDCT of trachea and main bronchi. Radiol Clin North Am. 48(1):157-76, 2010
                                      18. Lee KS et al: Update on multidetector computed tomography imaging of the airways. J Thorac Imaging. 25(2):112-24, 2010
                                      19. Grenier P: Multidetector CT evaluation of tracheobronchomalacia. In Imaging of Airways Disease. Radiologic Clinics of North America. 261-70, 2009
                                      20. Sverzellati N et al: Airway malacia in chronic obstructive pulmonary disease: prevalence, morphology and relationship with emphysema, bronchiectasis and bronchial wall thickening. Eur Radiol. 19(7):1669-78, 2009
                                      21. Heyer CM et al: Tracheobronchial anomalies and stenoses: detection with low-dose multidetector CT with virtual tracheobronchoscopy--comparison with flexible tracheobronchoscopy. Radiology. 242(2):542-9, 2007
                                      22. Boiselle PM et al: Tracheal morphology in patients with tracheomalacia: prevalence of inspiratory lunate and expiratory "frown" shapes. J Thorac Imaging. 21(3):190-6, 2006
                                      23. Baroni RH et al: Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology. 235(2):635-41, 2005
                                      24. Carden KA et al: Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 127(3):984-1005, 2005
                                      25. Boiselle PM et al: Tracheobronchomalacia: evolving role of dynamic multislice helical CT. Radiol Clin North Am. 41(3):627-36, 2003
                                      26. Hasegawa I et al: Tracheomalacia incidentally detected on CT pulmonary angiography of patients with suspected pulmonary embolism. AJR Am J Roentgenol. 181(6):1505-9, 2003
                                      27. Zhang J et al: 2003 AUR Memorial Award. Dynamic expiratory volumetric CT imaging of the central airways: comparison of standard-dose and low-dose techniques. Acad Radiol. 10(7):719-24, 2003
                                      28. Gilkeson RC et al: Tracheobronchomalacia: dynamic airway evaluation with multidetector CT. AJR Am J Roentgenol. 176(1):205-10, 2001
                                      29. Marom EM et al: Focal abnormalities of the trachea and main bronchi. AJR Am J Roentgenol. 176(3):707-11, 2001
                                      30. Suto Y et al: Evaluation of tracheal collapsibility in patients with tracheomalacia using dynamic MR imaging during coughing. AJR Am J Roentgenol. 171(2):393-4, 1998
                                      31. Stern EJ et al: Normal trachea during forced expiration: dynamic CT measurements. Radiology. 187(1):27-31, 1993
                                      32. Breatnach E et al: Dimensions of the normal human trachea. AJR Am J Roentgenol. 142(5):903-6, 1984
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Tracheomalacia, bronchomalacia

                                                • Definitions

                                                  • Increased compliance and excessive collapsibility of trachea &/or bronchi

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Fluoroscopic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Dubey S et al: Respiratory subtype of relapsing polychondritis frequently presents as difficult asthma: a descriptive study of respiratory involvement in relapsing polychondritis with 13 patients from a single UK centre. ERJ Open Res. 7(1), 2021
                                                                          2. Lima E et al: What is the optimal large airway size reduction value to determine malacia: exploratory bronchoscopic analysis in patients in Mounier-Kuhn syndrome. J Thorac Dis. 13(1):5-429, 2021
                                                                          3. Hysinger EB et al: Ultrashort echo-time MRI for the assessment of tracheomalacia in neonates. Chest. 157(3):595-602, 2020
                                                                          4. Mittal A et al: Chronic vaping related tracheomalacia (TM): a case of vaping induced altered innate immunity that culminated in severe TM. Cureus. 12(4):e7571, 2020
                                                                          5. Muthialu N et al: Management of tracheal diseases in children. Front Pediatr. 8:297, 2020
                                                                          6. Ren W et al: Prolonged endotracheal intubation: a feasible option for tracheomalacia after retrosternal goitre surgery. Ann Palliat Med. 9(4):1764-9, 2020
                                                                          7. Les AS et al: 3D-printed, externally-implanted, bioresorbable airway splints for severe tracheobronchomalacia. Laryngoscope. 129(8):1763-71, 2019
                                                                          8. Wallis C et al: ERS statement on tracheomalacia and bronchomalacia in children. Eur Respir J. 54(3), 2019
                                                                          9. Kheir F et al: Tracheobronchomalacia and excessive dynamic airway collapse: medical and surgical treatment. Semin Respir Crit Care Med. 39(6):667-73, 2018
                                                                          10. McInnis MC et al: Advanced technologies for imaging and visualization of the tracheobronchial tree: from computed tomography and MRI to virtual endoscopy. Thorac Surg Clin. 28(2):127-37, 2018
                                                                          11. Shepard JO et al: Imaging of the trachea. Ann Cardiothorac Surg. 7(2):197-209, 2018
                                                                          12. Buitrago DH et al: Current concepts in severe adult tracheobronchomalacia: evaluation and treatment. J Thorac Dis. 9(1):E57-66, 2017
                                                                          13. Burke AP et al: Diseases of the trachea and bronchi practical thoracic pathology. In Diseases of the Lung, Heart and Thymus. Wolters Kluwer. 47-154, 2017
                                                                          14. Luo M et al: Diagnostic Value of multidetector CT and its multiplanar reformation, volume rendering and virtual bronchoscopy postprocessing techniques for primary trachea and main bronchus tumors. PLoS One. 10(9):e0137329, 2015
                                                                          15. Ridge CA et al: Tracheobronchomalacia: current concepts and controversies. J Thorac Imaging. 26(4):278-89, 2011
                                                                          16. Gaissert HA et al: The compromised airway: tumors, strictures, and tracheomalacia. Surg Clin North Am. 90(5):1065-89, 2010
                                                                          17. Javidan-Nejad C: MDCT of trachea and main bronchi. Radiol Clin North Am. 48(1):157-76, 2010
                                                                          18. Lee KS et al: Update on multidetector computed tomography imaging of the airways. J Thorac Imaging. 25(2):112-24, 2010
                                                                          19. Grenier P: Multidetector CT evaluation of tracheobronchomalacia. In Imaging of Airways Disease. Radiologic Clinics of North America. 261-70, 2009
                                                                          20. Sverzellati N et al: Airway malacia in chronic obstructive pulmonary disease: prevalence, morphology and relationship with emphysema, bronchiectasis and bronchial wall thickening. Eur Radiol. 19(7):1669-78, 2009
                                                                          21. Heyer CM et al: Tracheobronchial anomalies and stenoses: detection with low-dose multidetector CT with virtual tracheobronchoscopy--comparison with flexible tracheobronchoscopy. Radiology. 242(2):542-9, 2007
                                                                          22. Boiselle PM et al: Tracheal morphology in patients with tracheomalacia: prevalence of inspiratory lunate and expiratory "frown" shapes. J Thorac Imaging. 21(3):190-6, 2006
                                                                          23. Baroni RH et al: Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology. 235(2):635-41, 2005
                                                                          24. Carden KA et al: Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 127(3):984-1005, 2005
                                                                          25. Boiselle PM et al: Tracheobronchomalacia: evolving role of dynamic multislice helical CT. Radiol Clin North Am. 41(3):627-36, 2003
                                                                          26. Hasegawa I et al: Tracheomalacia incidentally detected on CT pulmonary angiography of patients with suspected pulmonary embolism. AJR Am J Roentgenol. 181(6):1505-9, 2003
                                                                          27. Zhang J et al: 2003 AUR Memorial Award. Dynamic expiratory volumetric CT imaging of the central airways: comparison of standard-dose and low-dose techniques. Acad Radiol. 10(7):719-24, 2003
                                                                          28. Gilkeson RC et al: Tracheobronchomalacia: dynamic airway evaluation with multidetector CT. AJR Am J Roentgenol. 176(1):205-10, 2001
                                                                          29. Marom EM et al: Focal abnormalities of the trachea and main bronchi. AJR Am J Roentgenol. 176(3):707-11, 2001
                                                                          30. Suto Y et al: Evaluation of tracheal collapsibility in patients with tracheomalacia using dynamic MR imaging during coughing. AJR Am J Roentgenol. 171(2):393-4, 1998
                                                                          31. Stern EJ et al: Normal trachea during forced expiration: dynamic CT measurements. Radiology. 187(1):27-31, 1993
                                                                          32. Breatnach E et al: Dimensions of the normal human trachea. AJR Am J Roentgenol. 142(5):903-6, 1984