Tracheobronchomalacia and Expiratory Collapse of Central Airways

Tracheobronchomalacia is an uncommon acquired disorder of the central airways. Common symptoms include dyspnea, constant coughing, inability to raise secretions, and recurrent respiratory infections. Evaluation includes an inspiratory-expiratory chest CT (dynamic CT), an awake functional bronchoscopy, and pulmonary function studies. Patients with significant associated symptoms and severe collapse on CT and bronchoscopy are offered membranous wall plication. Tracheobronchoplasty is performed through a right thoracotomy. The posterior airway is exposed after the azygous vein is ligated. Patients report generally good results with improvement of their symptoms. Quality of life is usually improved, whereas pulmonary function tests usually are not improved.