Tracheobronchomalacia

Tracheobronchomalacia
Other names	Excessive Dynamic Airway Collapse
Trachea anatomy
Specialty	Pulmonology
Symptoms	Chronic cough, stridor, inability to raise secretions, breathlessness
Usual onset	From birth (Congenital ), Adulthood (Acquired)
Duration	Congenital: Significant improvement after 18-24 months although some symptoms may be present for life. Acquired: Long-term.
Risk factors	Relapsing polychondritis, Chronic obstructive pulmonary disease, Asthma, Gastroesophageal reflux disease (GERD), Heritable connective tissue disorders (Particularly Ehlers-Danlos Syndrome), Prolonged tracheal intubation, Long-term use of inhaled corticosteroids
Diagnostic method	Bronchoscopy, Dynamic Expiratory Computed Tomography
Differential diagnosis	Asthma, Chronic Obstructive Pulmonary Disease (COPD), Bronchiectasis, Tracheal stenosis, Tracheal tumors, Laryngomalacia
Prevention	Treatment of inflammatory disorders of the airway, avoiding hard impacts
Treatment	Continuous Positive Airway Pressure (CPAP), Airway Stenting, Aortopexy, Tracheopexy, Tracheobronchoplasty
Prognosis	Variable: Disease can range from asymptomatic to life-threatening

Tracheobronchomalacia (TBM) is a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse.^[1] This condition can also affect the bronchi. There are two forms of this condition: primary TBM and secondary TBM. Primary TBM is congenital and starts as early as birth. It is mainly linked to genetic causes. Secondary TBM is acquired and starts in adulthood. It is mainly developed after an accident or chronic inflammation.^[2]

Tracheobronchomalacia may also occur in people who have normal cartilaginous structure of the trachea, but significant atrophy of the posterior wall, causing significant invagination of the trachea on expiration. In these cases it is more commonly known as excessive dynamic airway collapse (EDAC).