Tracheobronchomalacia (TBM) Care

Other lung conditions can cause symptoms that are similar to TBM. To ensure an accurate diagnosis, we offer you one-stop access to a team of different types of specialists.

Our providers will first ask about your symptoms and past health problems. Then, they’ll complete a thorough physical exam. They may also ask you to undergo two specialized medical tests to diagnose TBM: 

Dynamic Expiratory CT Scan: During a CT scan, you lie very still on a table while the technician takes multiple X-Rays of your throat and upper chest. A computer assembles these images to provide a detailed view of your airways.

To confirm or rule out a diagnosis of TBM, we conduct a dynamic expiratory CT scan. This means the CT scan will capture images of your airways as you breathe.

Dynamic Flexible Bronchoscopy: A bronchoscope is a long, thin, flexible tube that enables your doctor to look into your airways. This is the gold standard for diagnosing TBM. That’s because it allows your doctor to perform real-time examination of the airways while you breathe. It also provides information on the extent and location of airway collapse.

Your specialist will use the results of these tests to determine whether you have TBM and, if so, how severe it is.

The treatment option that is right for you depends on how severe your condition is and how much your airway narrow when you breathe. We focus treatment on controlling your symptoms. Your TBM treatment plan may include some combination of the following:

• Airway Oscillatory Devices (Flutter Valve): These hand-held devices help you clear your airways. You inhale, and then exhale forcefully. This helps clear phlegm and mucus.
• External Percussion Vests: These inflatable vests connect to a compressor and help clear your lungs of mucus and phlegm. In most cases, you’ll use these two or three times a day.
• Expectorant: This medication makes it easier for you to cough up mucus and phlegm, clearing the airways.
• Pulmonary Rehabilitation: This involves education and training to improve your quality of life. You will learn more about TBM, as well as how to:
  • Breathe more productively.
  • Conserve your energy.
  • Stay active.
• Pursed Lip Breathing: This is a breathing technique in which you inhale through your nose, while keeping your lips closed, and then exhale through tightly pursed lips. It is a simple yet effective way to slow your breathing and alleviate shortness of breath.
• CPAP or BiPap Devices: You use a continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPap) device while you sleep. Both devices increase the air pressure in your throat. Due to this, your airway doesn't collapse when you breathe.
• TBM Surgery: We are pioneers in surgical procedures for TBM.

BIDMC is a world leader in diagnosing and treating TBM. If you have TBM, you will benefit from our TBM Program which offers expertise from a multidisciplinary team. Depending on your needs, your care team may include a variety of specialists:

• Interventional pulmonologists
• Thoracic surgeons
• Ear, nose and throat specialists
• Speech pathologists
• Endocrinologists
• General pulmonologists
• Behavioral health providers
• Anesthesiologists
• Radiologists