The marked delay in onset of symptoms may also be explained by the lesser degree of mediastinal shift (Fig 2). Dynamic bronchoscopy revealed severe reduction in the airway lumen due to diffuse collapse of the anterior cartilaginous structures consistent with crescent type of tracheobronchomalacia (Fig 3) extending throughout the lower trachea, right main bronchus, and […]
Additional therapy might depend on extent of the disease. For focal malacia, surgical resection of the involved segment is often proposed in experienced centers. Stent insertion can be offered to nonsurgical candidates or as a therapeutic trial in patients being considered for surgery. In patients with multifocal or diffuse disease, a stent trial might also […]
It is also operator dependent and cannot fully visualize the airways in obese patients. Dynamic radiologic studies allow volumetric acquisition of data at both end-inspiration and during dynamic expiration. Paired inspiratory/expiratory dynamic CT, for example, displays anatomic detail of the airway and adjacent structures, allows objective interpretation and quantitative measurement of the degree of collapse, […]
In patients with postpneumonectomy syndrome, tracheobronchomalacia is presumed to occur secondary to prolonged compression of the cartilaginous rings between a great vessel (aorta or pulmonary artery) and the vertebral bodies. It may also result from chronic airway infection and inflammation in patients with difficulty clearing secretions. Malacia is usually noted in the main bronchus and […]
Postpneumonectomy syndrome is usually a delayed finding after pneumonectomy, with an estimated incidence of 1 in 640 pneumonectomies. It is more frequent when pneumonectomy is performed at an early age, probably because of increased elasticity and compliance of the lung and mediastinum during childhood and early youth. Originally described after right pneumonectomy, postpneumonectomy syndrome is […]
A 68-year-old man with a 20-year history of wheezing presented with a recent increase in dyspnea, productive cough, and inability to clear secretions. He denied fevers, rigors, chest pain, palpitations, lightheadedness, syncope, headaches, nasal symptoms, or gastroesophageal reflux. During the last 15 years, he received treatment with albuterol and ipratropium inhalers in addition to daily […]