Tracheobronchomalacia: When the Airways Collapse During Breathing
Tracheobronchomalacia (TBM) is a respiratory condition characterized by weakness of both the trachea and the main bronchi, the large airways that carry air into the lungs. This weakness causes excessive airway collapse during breathing, leading to reduced airflow and persistent respiratory symptoms.
Unlike tracheomalacia, which affects only the windpipe, tracheobronchomalacia involves a larger portion of the airway, often resulting in more severe symptoms. The condition is more commonly diagnosed in adults and may be associated with chronic lung disease, smoking, prolonged airway inflammation, or previous airway injury.
Symptoms:
Patients with tracheobronchomalacia often experience chronic cough, breathlessness, wheezing that does not improve with inhalers, recurrent chest infections, and a sensation of airway blockage, particularly during exhalation. Because symptoms resemble asthma or chronic obstructive pulmonary disease (COPD), the condition is frequently underdiagnosed.
Diagnosis:
Diagnosis typically involves bronchoscopy to observe airway collapse or dynamic imaging studies that evaluate airway structure during breathing, dynamic CT scan. Pulmonary function tests may also help assess airflow limitation.
Treatment:
Management focuses on improving airflow and reducing symptoms. Treatment options include airway clearance therapy, treatment of infections, breathing support such as CPAP, and in severe cases, airway stenting or surgery to strengthen the airway.
Early diagnosis and proper management can significantly improve breathing, reduce infections, and enhance overall quality of life for affected patients.