Optimal Management of Malacic Airway Syndromes

Abstract

Tracheobronchomalacia (TBM), although uncommon, is increasingly recognized as a medical condition that may require treatment among patients with pulmonary disorders.1,2 The diagnosis of TBM is now often made on a CT scan done for reasons other than the confirmation of a suspected diagnosis of TBM. These “incidental” diagnoses of TBM need to be viewed with caution, as radiographic abnormalities do not always correlate with physiologic effects. TBM most often co-exists with chronic obstructive pulmonary disease (COPD), and it remains difficult to judge to what extent each diagnosis contributes to the symptoms of each patient. Typical symptoms that patients seek treatment for include dyspnea, cough, inability to clear secretions, and recurrent pulmonary infections. TBM can be treated by airway stent insertion (self-expanding metallic or silicone) or by membranous wall tracheobronchoplasty.