CureTBM. All rights reserved. 

Looking for support? Have questions? Join us on Facebook

  • Facebook Social Icon
General Patient Information

What is Tracheobronchomalacia?

Tracheobronchomalacia (TBM) until recently was thought to be a rare condition that occurs when the walls of the airway (specifically the trachea and bronchi) are weak.  As more awareness and diagnostic understanding are being discovered, it is being realizing that TBM is not in fact rare, but rather under-diagnosed or mis-diagnosed. TBM may be hidden, or masked inside of another airway condition.

 

There are two forms of TBM:

               Congenital (or Primary) TBM - Develops during infancy or early childhood

               Secondary TBM - Usually seen in adults, may be the result of trauma or recurrent inflammation. 

 

Patients may initially be asymptomatic. In rare cases some patients may have severe collapse and only manifest mild to moderate symptoms.  Tracheonbronchomalacia, however, is  typically progressive and most patients  will eventually develop characteristic features

Causes

Symptoms 

  • Damage to the trachea due to a tracheostomy

  • Tracheal fractures / injury to the trachea

  • Compression of the trachea due to tumors or masses

  • Thyroid tumors

  • Dilated aortic or pulmonary arteries

  • Chronic irritation due to coughing, asthma, second hand
    smoke or inhaling irritants.

  • Shortness of breath

  • Cough, wheezing and/or stridor (barky cough)
    Click HERE to listen to the TBM Cough

  • Sputum retention (not being able to "clear")

  • Reoccurant respiratory infections

  • Frequent hospitalizations 

  • Choking episodes

Diagnosis

The first step in a successful diagnosis, is finding a healthcare provider who specializes in Tracheobronchomalacia. CureTBM works with the Chest Disease Center at Beth Israel Deaconess Medical Center (BIDMC), and the Esophageal and Airway Treatment Center at Boston Children's Hospital. Depending on your signs and symptoms, your healthcare provider may recommend some of the following tests:

 

  • Bronchoscopy - A procedure in which an instrument called a bronchoscope is inserted into the airways to see how the trachea is functions when the patient breathes in and out. The patient is under general anesthesia during this procedure.  

  • Comprehensive patient exam - A complete health history and consult with the patient and family. It is important to bring a list of medications, questions and symptoms to this appointment to discuss with your healthcare team. 

  • Dynamic airway CAT scan - A non-invasive procedure in which the patient lies still while X Ray images are collected of the patient's airways. 

  • Laryngoscopy: Some patients with TBM may also have a Laryngeal Cleft. A Laryngoscopy is a procedure in which the health care providor looks in the patients throat to note any abnormalities. 

  • Pulmonary Function Test - A physical test in which the patient, while being monitored, is asked to complete several tasks, such as a 6 minute walk. This test gathers information about what the patient is capable of doing, and how the airway responds to activity. 

  • Swallowing studies - A procedure in which the patient remain's awake to drink and eat a variety of consistencies of food which are mixed with contrast. Images are then taken at certain points of the patient swallowing to determine if the patient aspirates while swallowing. 

Patient with Normal Airway

Patient with Collapsing Airway 

Treatment

Treatment options will very depending on your symptoms, diagnosis and physicians recommendations. Some options may include: 

  • Medications

  • Respiratory therapy

  • Silicone and/or long-term stenting

  • Surgical correction

  • Continuous positive airway pressure (CPAP)

  • Tracheostomy

Prognosis / Outcome

The prognosis for patients with Tracheobronchomalacia often depends on the underlying cause, as well as the care they receive. That is, the prognosis will vary greatly if the patient has been accurately diagnoses with Tracheobronchomalacia. 

In children, the prognosis is often very good, as some, not all of the malacia (weakening) may get stronger as the child grows. Over time, a child's cartilage will naturally stiffen, reducing the amount of airway collapse. However, most children will still need medical intervention.

For adults, Tracheobronchomalacia tends to worsen over time. While the actual disease may not worsen, the patient's ability to respond and recover may lessen as age increases. Without medical intervention, TBM can be life threatening.