Dynamic tracheal collapse

Dynamic tracheal collapse refers to collapse of the trachea during expiration. It is perhaps best assessed on CT in the end expiratory phase. An inspiratory series is also useful for comparative purposes. The term excessive dynamic airway collapse (EDAC) refers to abnormal and exaggerated bulging of the posterior wall within the airway lumen during exhalation, and is often termed pathological if the reduced airway lumen is <50% of normal during this phase.

Clinical presentation

It may cause a variety of symptoms such as dyspnea, wheeze, and exercise intolerance.

Pathology

The posterior cartilage free tracheal membrane bulges forwards excessively during expiration. It can be observed in the number of conditions:

• tracheomalacia
• Mounier-Kuhn syndrome: background tracheal dilatation
• relapsing polychondritis: background tracheal cartilage thickening
• chronic obstructive pulmonary disease (COPD): can be observed in a subset of COPD patients

Treatment and prognosis

The prognosis depends of the severity of the condition. Varied management strategies have been proposed with some authors suggested tracheoplasty for selected cases .