Clinical advances in the evaluation of patients with excessive central airway collapse: a narrative review

Abstract

The aim of this literature review is to clearly define excessive central airway collapse or ECAC, the underlying p a t h o p h y s i o l o g y, d i s c u s s p a t i e n t s y m p t o m s a n d comorbidities, relevant investigations and bronchoscopic evaluation. It is complimentary to a comprehensive series of review articles addressing all aspects of ECAC. Therapeutic bronchoscopy, stent trials and surgical management are outside the scope of this review. A search of PubMed and Google scholar was conducted using the term 'Excessive central airway collapse', results were limited to the period 2000-2021, research studies, with full text availability and English language. We present the following article in accordance with the Narrative Review reporting checklist

Tracheobronchomalacia following allogeneic haematopoietic stem cell transplantation

“… 12 The biphasic pattern is marked by a sudden and significant drop in airflow at the beginning of expiration, followed by a plateau of low flow. 6 Our cases illustrate a distinctive biphasic pattern on the flow‐volume loop during expiration, which is considered one of the hallmarks of TBM.…”

“…There are differences in the nature and management between TBM and BOS. TBM is characterized by a loss of cartilaginous integrity of the trachea or bronchi 6 . TBM is caused by the pathological collapse of airway lumen at the anterolateral wall, resulting in symptoms such as intractable cough, wheezing, dyspnea, and recurrent bronchitis or pneumonia 7,8 .…”

“…The spirometry results in patients with TBM can exhibit various patterns, including a normal flow‐volume loop, notching of the flow‐volume loop, an oscillation pattern, and a biphasic pattern 12 . The biphasic pattern is marked by a sudden and significant drop in airflow at the beginning of expiration, followed by a plateau of low flow 6 . Our cases illustrate a distinctive biphasic pattern on the flow‐volume loop during expiration, which is considered one of the hallmarks of TBM.…”

“…TBM is characterized by a loss of cartilaginous integrity of the trachea or bronchi. 6 TBM is caused by the pathological collapse of airway lumen at the anterolateral wall, resulting in symptoms such as intractable cough, wheezing, dyspnea, and recurrent bronchitis or pneumonia. 7 , 8 In contrast, BOS is the most prevalent late noninfectious pulmonary complication in patients who underwent allogeneic HSCT.…”