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Hester F Shieh, C Jason Smithers, Thomas E Hamilton, David Zurakowski, Gary A Visner, Michael A Manfredi, Russell W Jennings, Christopher W Baird
OBJECTIVE: Posterior descending aortopexy can relieve posterior intrusion of the left mainstem bronchus that may limit the effectiveness of posterior tracheobronchopexy. We review outcomes of patients undergoing both descending aortopexy and posterior tracheopexy for severe tracheobronchomalacia with posterior intrusion and left mainstem compression to determine if there were resolution of clinical symptoms and bronchoscopic evidence of improvement in airway collapse. METHODS: All patients who underwent both descending aortopexy and posterior tracheopexy from October 2012 to October 2016 were retrospectively reviewed...
March 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Friso M Rijnberg, Colin R Butler, Christian Bieli, Sonia Kumar, Reza Nouraei, Joshua Asto, Eimear McKavanagh, Paolo de Coppi, Nagarajan Muthialu, Martin J Elliott, Richard J Hewitt
OBJECTIVES: Our study describes and analyses the results from aortopexy for the treatment of airway malacia in children. METHODS: Demographic data, characteristics and preoperative, operative and outcome details, including the need for reintervention, were collected for children undergoing aortopexy between 2006 and 2016. RESULTS: One hundred patients [median age 8.2 months, interquartile range (IQR) 3.3-26.0 months] underwent aortopexy...
March 5, 2018: European Journal of Cardio-thoracic Surgery
Yuttiwat Vorakunthada, Weerapong Lilitwat
Tracheobronchomalacia (TBM) is characterized by weakness of cartilaginous supporting structures of tracheal and bronchial walls, resulting in central airway obstruction. It is a rare condition that can occur after prolonged intubation. Here, we report a 26-year-old, alcoholic male who had TBM, mild subglottic, and severe tracheal stenosis following 2 weeks of intubation. Subglottic and tracheal stenosis can occur after extubation but TBM is uncommon. The exact mechanism is still unknown but post-intubation TBM is a life-threatening condition with high morbidity and mortality if left untreated...
2018: Respiratory Medicine Case Reports
Changwan Ryu, Daniel Boffa, Kyle Bramley, Margaret Pisani, Jonathan Puchalski
RATIONALE: Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation. PATIENT CONCERNS: We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM. DIAGNOSES: An emergent bronchoscopy showed an actively bleeding, pulsatile vessel at the distal end of the left bronchial limb of the Y-stent...
February 2018: Medicine (Baltimore)
Kendra Hammond, Uzair K Ghori, Ali I Musani
Tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC) are more frequently being recognized as the etiology of multiple types of respiratory complaints from chronic cough to exertional syncope to recurrent infections. Identification of these conditions requires a high suspicion, as well as a thorough history and physical examination. Dynamic computed tomography imaging and bronchoscopic evaluation are integral in achieving an accurate diagnosis. Once recognized, treatment ranges from addressing underlying contributing conditions to surgical stabilization of the airway...
March 2018: Clinics in Chest Medicine
B Gerhardt, L Leesman, K Burra, J Snowball, Racheal Rosenzweig, Natalie Guzman, M Ambalavanan, D Sinner
Tracheobronchomalacia (TBM) is a common congenital disorder in which the cartilaginous rings of the trachea are weakened or missing. Despite the high prevalence and clinical issues associated with TBM, the etiology is largely unknown. Our previous studies demonstrated that Wntless (Wls) and its associated Wnt pathways are critical for patterning of the upper airways. Deletion of Wls in respiratory endoderm caused TBM and ectopic trachealis muscle. To understand mechanisms by which Wls mediates tracheal patterning, we performed RNA sequencing in prechondrogenic tracheal tissue of Wlsf/f;ShhCre/wt embryos...
February 8, 2018: Developmental Biology
Lan Li, Qaing Chen, Fan Zhang, Shuang-Gui Zhu, Ci-Lang Hu, Ai-Min Wu
OBJECTIVE: To investigate the characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia (TBM). METHODS: In this study, 30 children who were diagnosed with TBM using electronic bronchoscopy were enrolled in the observation group; 30 healthy children were recruited in the normal control group. For individuals in each group, the assessment of tidal breath pulmonary function was performed at diagnosis and 3, 6, 9, and 12 months after diagnosis...
December 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Evan J Propst, Faisal Zawawi, Roxanne E Kirsch, Osami Honjo
An infant with pulmonary atresia/ventricular septal defect/major aortopulmonary collateral arteries underwent unifocalization, ventriculoseptal defect closure and placement of a right ventricle to pulmonary artery conduit via median sternotomy. Aortopexy and pulmonary arteriopexy via redo sternotomy were insufficient to allow weaning of continuous positive airway pressure and he required direct tracheobronchopexy via left lateral thoracotomy to alleviate posterior trachealis intrusion along the length of the trachea and left main bronchus...
December 2017: International Journal of Pediatric Otorhinolaryngology
Colin Wallis, Clare A McLaren
Tracheobronchomalacia is a rare but clinically troublesome condition in paediatrics. The softening of the major airways - which can include some or all of the tracheobronchial tree can lead to symptoms ranging from the minor (harsh barking cough, recurrent chest infections) to severe respiratory difficulties including prolonged ventilator support and 'near death attacks'. The causes are broadly divided into intrinsic softening of the airway wall which is considered a primary defect (e.g. syndromes; post tracheo-oesophageal fistula repair; extreme prematurity) or secondary malacia due to external compression from vascular structures or cardiac components...
October 13, 2017: Paediatric Respiratory Reviews
Nicola Ullmann, Aurelio Secinaro, Laura Menchini, Serena Caggiano, Elisabetta Verrillo, Teresa Pia Santangelo, Renato Cutrera, Paolo Tomà
BACKGROUND: Tracheobronchomalacia, defined as variable collapse of the airways, has been recognized as an important cause of respiratory morbidity but still widely underdiagnosed. Bronchoscopy is still considered as the gold standard, but numerous limitations are known, especially for fragile sick children. Moreover, information on parenchymal lung disease cannot be described. There is a real need for a reliable, non-invasive test to help detection of airway and parenchymal malformations in children, specifically when bronchoscopy cannot be performed...
January 2018: Pediatric Pulmonology
Ashish Kumar Roy, Moni Roy, Ghaly Kerolus
Tracheomalacia patients often present with nonspecific symptoms like cough, wheezing and dyspnea. Tracheomalacia diagnosis is usually attributed to alternative common conditions such as asthma or chronic obstructive lung disease. Certain maneuvers, like forced expiration, or recumbent position may elicit subtle signs of tracheomalacia. Ordering novel pulmonary function testing in sitting upright and supine positions may provide additional clues to suspect tracheomalacia, which can be confirmed by either dynamic chest tomography or bronchoscopy...
2017: Journal of Community Hospital Internal Medicine Perspectives
Daisuke Oryoji, Nobuyuki Ono, Daisuke Himeji, Kyoko Yoshihiro, Yasufumi Kai, Motohiro Matsuda, Hiroshi Tsukamoto, Akira Ueda
Relapsing polychondritis (RP) is a rare systemic autoimmune disease that affects cartilaginous structures. RP causes tracheobronchomalacia (TBM) by affecting the bronchial cartilage. TBM is a fatal condition characterized by excessive weakening of the walls of the trachea and bronchi. We herein report a case of a 73-year-old man who experienced sudden respiratory failure due to TBM caused by RP. Immunosuppressive treatment did not improve his respiratory failure. Multiple metallic stentings dramatically improved his severe airway symptoms...
October 11, 2017: Internal Medicine
Stefani M Schwartz, Katherine J Greco, Venugopal Reddy
BACKGROUND Pulmonary embolism is a common acute postoperative complication and is associated with 100,000 deaths per year in the USA. Tracheobronchomalacia is an uncommon condition, which presents with similar symptoms to pulmonary embolism, including hypoxemia, tachycardia, and shortness of breath. We describe a case of a patient who presented with postoperative pulmonary symptoms that were initially thought to be due to pulmonary embolism. However, following imaging investigations these symptoms were found to be due to tracheobronchomalacia...
September 19, 2017: American Journal of Case Reports
Richard P Boesch, Julie M Baughn, Shelagh A Cofer, Karthik Balakrishnan
AIM: Persistent or recurrent wheezing is a common indication for flexible bronchoscopy, as anatomic and infectious or inflammatory changes are highly prevalent. We sought to evaluate the prevalence of anatomic, infectious, and inflammatory disease in a cohort of children undergoing flexible bronchoscopy for wheezing or poorly controlled asthma. METHODS: We retrospectively reviewed all children <18 years old who underwent flexible bronchoscopy at our center from October 29, 2012-December 31, 2016 for the primary or secondary indication of wheezing (persistent, frequently recurring, or atypical) or poorly controlled asthma...
September 14, 2017: Pediatric Pulmonology
Sharon D Dell
No abstract text is available yet for this article.
September 2017: Annals of the American Thoracic Society
Pierluigi Ciet, Phillip M Boiselle, Benedikt Heidinger, Eleni-Rosalina Andrinopoulou, Carl O'Donnel, David C Alsop, Diana E Litmanovich
OBJECTIVE: Bronchoscopy and MDCT are routinely used to assess tracheobronchomalacia (TBM). Recently, dynamic MRI (cine MRI) has been proposed as a radiation-free alternative to MDCT. In this study, we tested cine MRI assessment of airway dynamics during various breathing conditions and compared cine MRI and MDCT measurements in healthy volunteers and patients with suspected TBM. CONCLUSION: Cine MRI was found to be a technically feasible alternative to MDCT for assessing central airway dynamics...
October 2017: AJR. American Journal of Roentgenology
Faraz Afridi, Seema Frosh
Relapsing polychondritis is a very rare autoimmune disease characterised by a relapsing inflammation of hyaline, elastic and fibrous cartilaginous tissues. The incidence is estimated to be between 3.5 and 4.5 per million people per year. Clinical signs and symptoms can be very subtle, and if left undiagnosed for a prolonged period, airway involvement can cause fibrosis of the tracheobronchial wall, leading to a fixed tracheobronchial stenosis. Eventually, this can progress to life-threatening tracheobronchomalacia due to irreversible damage and loss of tissue integrity...
July 24, 2017: BMJ Case Reports
Erik B Hysinger, Nicholas L Friedman, Michael A Padula, Russell T Shinohara, Huayan Zhang, Howard B Panitch, Steven M Kawut
RATIONALE: Tracheobronchomalacia is a common comorbidity in neonates with bronchopulmonary dysplasia. However, the effect of tracheobronchomalacia on the clinical course of bronchopulmonary dysplasia is not well-understood. OBJECTIVE: We sought to assess the impact of tracheobronchomalacia on outcomes in neonates with bronchopulmonary dysplasia in a large, multi-center cohort. METHODS: We preformed a cohort study of 974 neonates with bronchopulmonary dysplasia admitted to 27 neonatal intensive care units participating in the Children's Hospital Neonatal Database who had undergone bronchoscopy...
June 16, 2017: Annals of the American Thoracic Society
J W Wang, S H Jiang
No abstract text is available yet for this article.
June 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
Jerrold B Leikin
No abstract text is available yet for this article.
October 2017: Disease-a-month: DM
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