The Tracheobronchomalacia (TBM) Program at Brigham and Women’s Hospital offers a team-based approach to the diagnosis and treatment of TBM. We combine the expertise of different specialists working together to offer you the best possible care.
Our TBM program offers:
Tracheomalacia is an airway disorder where the trachea (windpipe) is floppy or abnormally collapsible. Sometimes the main bronchial tubes (airways in the lungs) are also abnormally floppy and the broader term tracheobronchomalacia (TBM) is used.
TBM can happen in one of two ways:
Symptoms can include:
Sometimes the cough associated with TBM has a particular sound. However, the symptoms of TBM are often very similar to the symptoms of other common airway diseases, such as asthma, bronchitis and chronic obstructive pulmonary disease (COPD). This means your doctor may need to run additional tests to diagnose TBM and rule out other conditions with similar symptoms.
People of any age or background can get TBM. Most often the cause of TBM is unknown. In some cases, risk factors include:
No one knows exactly how common TBM is in the general population because mild cases don’t cause symptoms. Also, not all doctors have been trained to diagnose TBM because diseases like asthma and COPD that can mimic TBM are much more common.
There are certain tests your doctor may recommend.
Because TBM is a structural problem, surgery is needed to repair it. This repair surgery is called a tracheoplasty. Traditionally, surgery has required a major chest incision. At Brigham and Women’s Hospital, we offer a minimally-invasive approach that avoids large incisions. Our minimally invasive surgery has less risk, less pain following surgery and a much shorter recovery time than traditional surgery. Our new approach uses robotic surgery, which is when your surgeon uses special instruments that can make tiny incisions.
No. We have a standard approach to find out who is a good candidate for surgery. To find out if TBM surgery (tracheoplasty) can help improve your symptoms, we temporarily place a stent (plastic tube) inside the central airways. The stent sits inside your windpipe and its main branches and prevents these airways from collapsing when you breathe out. If the stent resolves your breathing problems, you will most likely benefit from TBM surgery. Because stents can irritate the tracheal wall if they are used long term, they can’t be left in permanently. Tracheoplasty surgery is the long-term solution for TBM. Symptoms like cough, shortness of breath, wheezing and trouble clearing excess secretions from the airways usually improve after the surgery.
There are medical options that can help treat TBM, although they don’t cure it.
Treatments may include:
If you are coming from afar, we can arrange for coordinated initial consultations on the same day. Pulmonary (lung) function testing and possible placement of a tracheal stent (a stent trial) will be scheduled if needed.
Our team-based consultation, specialized testing and surgeries are performed at Brigham and Women’s Hospital in the Longwood Medical Area in Boston. However, you can also make appointments with our TBM experts at Brigham and Women’s Faulkner Hospital in Jamaica Plain, Brigham and Women’s Ambulatory Care Center in Chestnut Hill and Patriot Place in Foxboro.
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