Expiratory Central Airway Collapse: A Comprehensive Narrative Review

Abstract

Expiratory central airway collapse (ECAC) encompasses 2 subtypes: excessive dynamic airway collapse and tracheobronchomalacia. ECAC manifests as symptoms of dyspnea, chronic cough, difficulty in clearing secretions, and recurrent respiratory infections. Diagnosis involves dynamic flexible bronchoscopy and computed tomography scans. Medical management addresses respiratory symptoms and concurrent conditions like chronic obstructive pulmonary disease, asthma, gastroesophageal reflux disease, and paroxysmal vocal fold motion. Selected patients may benefit from stent trials to assess candidacy for tracheobronchoplasty (TBP). Positive stent trials predict successful TBP outcomes, enhancing respiratory symptoms and quality-of-life. Alternative therapeutic options include long-term stenting and intermittent positive airway pressure therapy.

Keywords: Bronchomalacia; Dynamic bronchoscopy; Excessive dynamic airway collapse; Expiratory central airway collapse; Stent trial; Tracheobronchomalacia; Tracheobronchoplasty; Tracheomalacia.