Central (Tracheobronchial) Airway Obstruction

Epidemiology

  • xxx

Etiology

Tracheobronchial Infection

Tracheobronchial Neoplasm

Primary Tracheobronchial Tumor

Endobronchial Metastases (see also Lung Metastases-Endobronchial, [[Lung Metastases-Endobronchial]])

Extrinsic Tracheobronchial Compression

  • Enlarged Pulmonary Artery: extrinsic compression of tracheobronchial airways
    • Tetralogy of Fallot (see Tetralogy of Fallot, [[Tetralogy of Fallot]]): in infants and children
    • Transposition of Great Vessles with Ventricular Septal Defect: in infants and children
  • Granulomatous Mediastinitis and Fibrosing Mediastinitis (see Granulomatous Mediastinitis and Fibrosing Mediastinitis, [[Granulomatous Mediastinitis and Fibrosing Mediastinitis]])
    • Physiology: extrinsic compression of tracheobronchial airways
  • Mediastinal Mass (see Mediastinal Mass, [[Mediastinal Mass]]): extrinsic compression of tracheobronchial airways
    • Bulky Mediastinal or Peribronchial Lymphadenopathy
      • Cancer
      • Hodgkin’s Disease (see Hodgkin’s Disease, [[Hodgkins Disease]])
      • Lymphoma (see Lymphoma, [[Lymphoma]])
      • Tuberculosis (see Tuberculosis, [[Tuberculosis]]): involvement of mediastinal nodes may compress RML bronchus
      • Sarcoidosis (see Sarcoidosis, [[Sarcoidosis]])
    • Mediastinal Tumor
  • Thoracic Aortic Aneurysm (TAA) (see Thoracic Aortic Aneurysm, [[Thoracic Aortic Aneurysm]]): extrinsic compression of tracheobronchial airways
  • Thyroid Cancer/Thyromegaly/Goiter (see Goiter, [[Goiter]] and Thyroid Cancer, [[Thyroid Cancer]])
    • Physiology: extrinsic compression of trachea

Other Tracheobronchial Obstructive Process

  • Amyloidosis (see Amyloidosis, [[Amyloidosis]])
  • Blood Clot
    • Epidemiology: airway occlusion by blood clots typically occurs following significant hemoptysis
  • Bronchial Stenosis (see Bronchial Stenosis, [[Bronchial Stenosis]])
  • Bronchocentric Granulomatosis (see Bronchocentric Granulomatosis, [[Bronchocentric Granulomatosis]])
  • Broncholithiasis (see Broncholithiasis, [[Broncholithiasis]])
  • Bronchopulmonary Amyloidosis (see Amyloidosis, [[Amyloidosis]])
  • Goiter
  • Granulation Tissue
    • Airway Foreign Body
    • Airway Stent
    • Endotracheal Tube
    • Surgical Airway Anastomosis (see Lung Transplant, [[Lung Transplant]])
    • Tracheostomy Tube
  • Hunter’s Syndrome
    • Epidemiology: with tracheal stenosis
  • Hurler’s Syndrome
    • Epidemiology: with tracheal stenosis
  • Mucous Plug (see Mucous Plug, [[Mucous Plug]])
    • Epidemiology: tracheobronchial obstruction by mucous plugging is common in patients with lung disease and infection in the ICU setting
  • Mucoid Impaction (see Mucoid Impaction, [[Mucoid Impaction]])
    • Physiology: tracheobronchial obstruction
  • Post-Extubation Tracheal Edema
  • Post-Pneumonectomy Syndrome (see Post-Pneumonectomy Syndrome, [[Post-Pneumonectomy Syndrome]])
  • Post-Radiation Therapy (see Radiation Therapy, [[Radiation Therapy]])
    • Physiology: bronchial granulation tissue (or stricture)
  • Relapsing Polychondritis (see Relapsing Polychondritis, [[Relapsing Polychondritis]])
    • Physiology: endotracheal or endobronchial obstruction by loss of supporting cartilage in airways
  • Saber Sheath Trachea (see Saber Sheath Trachea, [[Saber Sheath Trachea]])
  • Smoke Inhalation (see Smoke Inhalation, [[Smoke Inhalation]])
    • Physiology: tracheobronchial mucosal injury with sloughing and airway obstruction
  • Toxic Fume Airway Injury
    • Physiology: tracheobronchial mucosal injury with sloughing and airway obstruction
  • Tracheal Cyst (see Tracheal Cyst, [[Tracheal Cyst]])
  • Tracheal Stenosis (see Tracheal Stenosis, [[Tracheal Stenosis]])
  • Tracheal Trauma
  • Tracheobronchial Foreign Body (see Foreign Body, [[Foreign Body]])
  • Tracheobronchial Fracture (see Tracheobronchial Fracture, [[Tracheobronchial Fracture]])
  • Tracheoesophageal Fistula (see Tracheoesophageal Fistula, [[Tracheoesophageal Fistula]])
  • Tracheobronchomalacia (see Tracheobronchomalacia, [[Tracheobronchomalacia]])
  • Tracheobronchial Web
    • Epidemiology
  • Tracheopathia Osteochondroplastica (see Tracheopathia Osteochondroplastica, [[Tracheopathia Osteochondroplastica]])
  • Wegener’s Granulomatosis (see Wegeners Granulomatosis, [[Wegeners Granulomatosis]])

Physiology

  • xxx

Diagnosis

Pulmonary Function Tests (PFT’s) (see xxxx, [[xxxx]])

  • xxx

Bronchoscopy (see xxxx, [[xxxx]])

  • xxxx

Clinical Manifestations

Pulmonary Manifestations

Obstructive Symptoms

  • Dyspnea (see xxxx, [[xxxx]])
  • Wheezing (see xxxx, [[xxxx]])

Treatment

XXXXXX

  • xxx

References

  • Central airway obstruction. Am J Respir Crit Care Med. 2004 Jun 15;169(12):1278-97 [MEDLINE]