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Adult Airway Conditions 

Tracheobronchomalacia (TBM) is a softening (malacia) of the trachea (windpipe) and bronchi (connectors to the lungs). A weak, or collapsing trachea can inhibit everyday activities such as eating, running, and overall breathing. Of interest, in TBM patients, the collapse is actually more significant when they exhale (breathe out). Activities such as coughing, laughing, and exercise will often make the airway collapse worse. 

 

The cause of Tracheobronchomalacia is somewhat idiopathic, or unknown. However, risk factors for TBM include tracheal fractures, tracheostomy, tumors, and chronic irritation from conditions such as asthma, coughing and/or second hand smoke. It is of note that  

Symptoms of Tracheobronchomalacia may include shortness of breath, chronic respiratory infections, frequent hospitalizations, and a "bark like" cough. Unfortunately, TBM is often misdiagnosed and/or under diagnosed because the symptoms may present themselves as another condition.

 

Diagnosing Tracheobronchomalacia requires a specialist such as those at Beth Israel Deaconess Medical Center. At BIDMC, specialists know the exact tests needed to look for TBM. Once a diagnosis of TBM is made, treatment options may include: 

  • Respiratory therapy - airway oscillatory device, external percussion vest, pursed lip breathing, pulmonary rehabilitation, Continuous Positive Airway Pressure (CPAP), Bilevel Positive Airway Pressure (BPAP)

  • Medication -  expectorants, suppressants, inhalers

  • Surgery - First a surgical stent is implanted into the patient's trachea for 1-2 weeks to see if symptoms of TBM get better. If symptoms improve during the stent trial, then a surgical procedure call a Tracheobronchoplasty is completed to provide more permanent relief.

Patient Stories

Jennifer Champy spent many years in respiratory distress and searching for answers. 

During Jennifer’s years of searching for a diagnosis and treatment options, she felt extremely isolated, afraid and confused with her health.  Read more

Nancy spent years fighting frequent respiratory illnesses and frequent hospitalizations. She was misdiagnosed with COPD, Asthma, Croup and respiratory

viruses. Nancy eventually became nearly bedridden because of her symptoms. Little did she know, help was around the corner. 

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Beth Israel Deaconess Medical Center (BIDMC)

Beth Israel Deaconess Medical Center (BIDMC) Chest Disease Center is the leading hospital for treating airway problems in adult patients. Because Tracheobronchomalacia is often misdiagnosed and/or under diagnosed is imperative to see a team who specialize in diagnosing this condition. Your team will include pulmonologists, thoracic surgeons, ear nose and throat specialists, speech pathologists, anesthesiologists and radiologists. This team will help provide a comprehensive health care plan to help treat your TBM. For more information or to schedule an appointment, contact the the TBM Program and Chest Disease Center at (617) 632-8252, or visit their website by clicking HERE. For information on "Why to Choose Beth Israel Deaconess Medical Center, click HERE. 

                   

BIDMC Team

Alex Chee, MD

Interventional Pulmonology

Sidhu Gangadharan, MD

 Chief, Thoracic Surgery & Interventional Pulmonology

Michael Kent, MD
Director, Minimally Invasive Thoracic Surgery

Adnan Majid, MD
Chief, Interventional Pulmonology

Mihir Parikh, MD
Inventional Pulmonology

Jennifer Wilson, MD

Thoracic Surgery

What is Tracheobronchomalacia (TBM)?
Beth Israel Deaconess Medical Center: Sandra Rocha
Doctors who partner with BIDMC

Frequently Asked Questions
Additional Patient Resources

Patients with Tracheobronchomalacia (TBM) may have difficulties clearing secretions in which respiratory aides such as airway oscillatory device, external percussion vest, pursed lip breathing, pulmonary rehabilitation, Continuous Positive Airway Pressure (CPAP), Bilevel Positive Airway Pressure (BPAP) are indicated. Additionally, breathing exercises to help strengthen the muscles may be indicated. 

In addition to the signs and symptoms associated directly with TBM, patients may also find they have difficulty controlling their weight. This can stem from prolonged oral steroid use, or reduced activity due to symptoms of TBM. It is important to remember diet and exercise, while difficult, are crucial in maintaining ones overall health and well being. Ask your healthcare provider about exercises that can be tailored to your abilities. 

Patients with TBM may also find their condition is worsened by other medical conditions, such as acid reflux. Acid reflux can be controlled by taking medications (either over the counter or prescribed) and by lifestyle changes. Patients with acid reflux find avoiding certain "trigger" foods (especially before bed), changing sleep position to either the left side or elevated, and chewing gum may help reduce acid reflux symptoms. Patients with acid reflux should mention this to their primary care provider, as well as their TBM treatment team. 

Acapella Vibratory PEP Therapy System

How CPAP Works

Lung Exercises

[Beth Israel Deaconess]. (2014, Jul 30). What is Tracheobronchomalacia (TBM)? [Video File]. Retrieved from https://www.youtube.com/watch?v=E8wL_mA4QGc

[Beth Israel Deaconess]. (2017, Oct 18). Beth Israel Deaconess Medical Center: Sandra Rocha. [Video File]. Retrieved from https://www.youtube.com/watch?v=Rwcc3mdu2sg

[Henleys Medical Supply]. (2013, Sept. 6). Acapella Vibratory PEP Mucus Clearance Device[Video File]. Retrieved from https://www.youtube.com/watch?v=jZCjMQAlGcU

[KenWarnerRemoteSleep]. (2011, May 23). How CPAP Works 5_23_11 [Video File]. Retrieved from https://www.youtube.com/watch?v=AUXYjPbNwqg

[Lungexercise]. (2010, Dec. 22). Lung Exercises: Open Chest Expands Lungs [Video File]. Retrieve from https://www.youtube.com/watch?v=iIrAUL_VmiU