Clinical characteristics of dynamic benign tracheobtonchial stenosis: two cases report_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

SUN Xiaofu ¹ ^# , LIU Chuntao ² , LUO Zhuang ³ ,  HU Liangan ¹

1. Department of Respiratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P. R. China;
2. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P. R. China;

Corresponding author：

HU Liangan, Email: 1015720187@qq.com

Keywords：

Dynamic benign tracheobronchial stenosis; Tracheobronchomalacia; Excessive dynamic airway collapse; Relapsing polychondritis; Bronchoscopy

DOI：

10.7507/1671-6205.201708024

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To improve the knowledge on dynamic benign central airway stenosis through two typical cases. Methods The clinical features, imaging findings, and bronchial morphologic changes of two cases characterized by dynamic benign central airway stenosis were retrospectively analyzed. The etiologies for the two cases were tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC), respectively. Results Central airway stenosis and reversible airway obstruction were common clinical characteristics for the two cases. However, there were identifiable differences on imaging findings and bronchial morphologic changes between the two cases. Multidetector computed tomography showed sabre-sheath trachea and narrowed trachea in coronal position for TBM, while small sized trachea in exhalation phase and narrowed trachea in sagittal position for EDAC. Bronchoscopy displayed narrowed airway, swelling mucosa, and the absence of annular cartilage for TBM, while crescent airway with membranacea part protruding to lumen in inspiration phase, and the integrity of annular cartilage for EDAC. Conclusion Multidetector computed tomography and bronchoscopy examinations are valid methods to distinguish TBM and EDAC, which are both characterized by dynamic benign central airway stenosis.

Citation： SUN Xiaofu, LIU Chuntao, LUO Zhuang, HU Liangan. Clinical characteristics of dynamic benign tracheobtonchial stenosis: two cases report. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(3): 275-278. doi: 10.7507/1671-6205.201708024 Copy

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12.	Ferretti GR, Jankowski A, Perrin MA, et al. Multi-detector CT evaluation in patients suspected of tracheobronchomalacia:comparison of end-expiratory with dynamic expiratory volumetric acquisitions. Eur J Radiol, 2008, 68(2): 340-346.
13.	Baroni RH, Feller-Kopman D, Nishino M, et al. Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology, 2005, 235(2): 635-641.
14.	Heidinger BH, Occhipinti M, Eisenberg RL, et al. Imaging of large airways disorders. AJR Am J Roentgenol, 2015, 205(1): 41-56.
15.	张家祺, 李强, 白冲, 等. 累及气道的复发性多软骨炎的临床特征及其处理. 中华结核和呼吸杂志, 2007, 30(3): 173-177.
16.	Mathew SD, Battafarano DF, Morris MJ. Relapsing polychongritis in the department of defense population and review of the liturature. Semin Arthritis Rheum, 2012, 42(1): 70-83.
17.	Majid A, Guerrero J, Gangadharan S, et al. Tracheobronchoplasty for severe tracheobronchomalacia: a prospective outcome analysis. Chest, 2008, 134(4): 801-807.
18.	Isa AY, Macandie C, Irvine BW. Nitinol stents in the treatment of benign proximal tracheal stenosis or tracheomalacia. J Laryngol Otol, 2006, 120(1): 32-37.
19.	Dutau H. Airway stenting for benign tracheal stenosis: what is really behind the choice of the stent? Eur J Cardiothorac Surg, 2011, 40(4): 924-925.

1. 王继旺, 蒋胜华. 气管支气管软化症与过度动态气道塌陷. 中华结核和呼吸杂志, 2017, 40(6): 469-472.
2. 李宁, 刘春涛, 王可, 等. 良性气道狭窄病因分析及治疗方式总结. 中国呼吸与危重监护杂志, 2012, 11(2): 179-181.
3. 中国医学会呼吸病学分会. 良性中央气道狭窄经支气管镜介入诊治专家共识. 中华结核和呼吸杂志, 2017, 40(6): 408-418.
4. Freitag L, Ernst A, Unger M, et al. A proposed classification system of central airway stenosis. Eur Respir J, 2007, 30(1): 7-12.
5. Myer CM, O'Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol, 1994, 103(4Pt1): 319-323.
6. Leong P, Bardin PG, Lau KK. What’s in a name? Expiratory tracheal narrowing in adults explained. Clin Radiol, 2013, 68(12): 1268-1275.
7. Majid A, Sosa AF, Ernst A, et al. Pulmonary function and flowvolume loop patterns in patients with tracheobroncheomalacia. Respir Care, 2013, 58(9): 1521-1526.
8. Ellingsen I, Holmedahl NH. Does excessive dynamic airway collapse have any impact on dynamic pulmonary function tests? J Bronchology Interv Pulmonol, 2014, 21(1): 40-46.
9. Boiselle PM, Michaud G, Roberts DH, et al. Dynamic expiratory tracheal collapse in COPD: correlation with clinical and physiologic parameters. chest, 2012, 142(6): 1539-1544.
10. Weinstein DJ, Hull JE, Ritchie BL, et al. Exercise-associated excessive dynamic airway collapse in military personnel. Ann Am Thorac Soc, 2016, 13(9): 1476-1482.
11. Lee KS, Sun MR, Ernst A, et al. Comparison of dynamic expiratory CT with bronchoscopy for diagnosing airway malacia: a pilot evaluation. Chest, 2007, 131(3): 758-764.
12. Ferretti GR, Jankowski A, Perrin MA, et al. Multi-detector CT evaluation in patients suspected of tracheobronchomalacia:comparison of end-expiratory with dynamic expiratory volumetric acquisitions. Eur J Radiol, 2008, 68(2): 340-346.
13. Baroni RH, Feller-Kopman D, Nishino M, et al. Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology, 2005, 235(2): 635-641.
14. Heidinger BH, Occhipinti M, Eisenberg RL, et al. Imaging of large airways disorders. AJR Am J Roentgenol, 2015, 205(1): 41-56.
15. 张家祺, 李强, 白冲, 等. 累及气道的复发性多软骨炎的临床特征及其处理. 中华结核和呼吸杂志, 2007, 30(3): 173-177.
16. Mathew SD, Battafarano DF, Morris MJ. Relapsing polychongritis in the department of defense population and review of the liturature. Semin Arthritis Rheum, 2012, 42(1): 70-83.
17. Majid A, Guerrero J, Gangadharan S, et al. Tracheobronchoplasty for severe tracheobronchomalacia: a prospective outcome analysis. Chest, 2008, 134(4): 801-807.
18. Isa AY, Macandie C, Irvine BW. Nitinol stents in the treatment of benign proximal tracheal stenosis or tracheomalacia. J Laryngol Otol, 2006, 120(1): 32-37.
19. Dutau H. Airway stenting for benign tracheal stenosis: what is really behind the choice of the stent? Eur J Cardiothorac Surg, 2011, 40(4): 924-925.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical characteristics of dynamic benign tracheobtonchial stenosis: two cases report

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