Tracheobronchomalacia

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Abstract
A 67-year-old man, with a 9-year history of chronic obstructive pulmonary disease and treated with bronchodilators and intermittent corticosteroids, was admitted to our medical center for acute hypercapnic respiratory failure requiring mechanical ventilation. A bronchoscopy was performed because of two episodes of unexplained acute carbon dioxide retention. Bronchoscopy showed narrowing and collapse of the distal trachea, and narrowing of the right and left main stem bronchi with mucosal protrusion. The appearance of the mucosa of the distal trachea and bronchi suggested chronic inflammation. The mucosal biopsies showed chronic inflammation and squamous metaplasia. A diagnosis of idiopathic tracheobronchomalacia was made and he was referred for tracheobronchial stent placement. Four months after placement of tracheal silastic stents his spirometry showed an increase in forced expiratory volume, 1 second, from 0.72 to 2.26 L, and an increase in forced vital capacity from 1.31 to 3.49 L.

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