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The symptoms of tracheobronchomalacia or excessive dynamic airway collapse include:

• Abnormal/Irregular breathing noises (such as rattling sounds)
• Chronic cough
• Difficulty swallowing, especially solid foods
• Recurring respiratory tract infections
• Shortness of breath

Your evaluation is customized to your condition. Your evaluation may include:

• A complete history of your breathing problem
• A physical examination of your head, neck, and chest
• Evaluation your breathing ability through pulmonary function testing (PFTs), and a 6 minute walk test
• Examination of your throat, voice box, and airway through endoscopy in the clinic or operating room
• Imaging of your airways via X-rays or computed tomography (CT) scans.  This may include dynamic 3D chest CT scans, a non-invasive procedure performed with the patient inhaling and exhaling to examine how the airways change with breathing.

Your doctor may recommend non-surgical or surgical treatment options depending on your symptoms and other factors.

Non-surgical treatment

In many cases, tracheobronchomalacia or excessive dynamic airway collapse gradually improves with improvement in contributing medical conditions.  However, patients who suffer from frequent respiratory infections or persistent symptoms should be closely monitored. Their options for treatment may include the following:

• Optimizing medically the conditions that could be exacerbating tracheobronchomalacia. 
• Chest physical therapy: non-invasive techniques that include lightly tapping on the chest to break up mucus, and deep breathing exercises.

Continuous positive airway pressure (CPAP): through a face mask, air under mild pressure forces the trachea to remain open during breathing.

Surgery

For patients who do not benefit from conservative treatment, we offer surgical procedures to improve symptoms with tracheobronchomalacia or excessive dynamic airway collapse.  These include:

• Tracheobronchial stenting: while examining your airway through the mouth while you are asleep, the airway is propped open with a thin metallic or silicone expandable stent placed into the airway through a bronchoscope. Most stents are placed as a trial to evaluate if splinting of the airway will improve symptoms before definitive treatment.
• Tracheal resection and reconstruction: via an incision through the neck or chest, the floppy area of the airway is cut away (resected), and the two remaining ends of the airway are sewn back together, resulting in an unobstructed airway. This procedure is best for patients with a small area of their airway affected.
• Endoscopic laser tracheobronchoplasty: while examining your airway through the mouth while you are asleep, a laser is used through a flexible scope to stiffen the tissues that collapse during breathing to improve the airway staying open.
• Open tracheobronchoplasty: a surgical procedure that provides support to the weak/floppy airway, preventing its collapse during breathing. Via an incision through the neck or chest, a mesh or surrounding tissue is placed as support, and the length of the floppy airway is sutured to it so that the airway is held in an open configuration during the breathing cycle.
• Tracheostomy: an incision is made from the front of the neck into the airway, and a tube is inserted into the airway to hold open the area of collapse and allow normal breathing.