Tracheobronchomalacia (TBM) Treatment at BIDMC

BIDMC offers advanced expertise in diagnosis and treating TBM, an under-diagnosed airway conditions that causes chronic cough and infections.


BIDMC is a world leader in diagnosing and treating tracheobronchomalacia (TBM). When you make an appointment with our TBM Program, you will benefit from the expertise of a multidisciplinary team of interventional pulmonologists, thoracic surgeons, ear/nose/throat specialists, speech pathologists, endocrinologists, general pulmonologists, behavioral health providers, anesthesiologists, and radiologists.

 

We evaluate and treat more patients with TBM than anywhere else in the United States. Through our TBM Program, we offer you an extraordinary level of expertise and care.

What is TBM?

Normally the central airways (the trachea and bronchi) remain open when you breathe. In TBM, the airways become weak and floppy, tending to collapse with breathing.

TBM is a rare condition, and often misdiagnosed. In most cases, it is not clear what causes TBM. Sometimes it can be seen at the same time as another lung disorder, such as COPD, asthma, or cystic fibrosis. Our researchers are working to understand the underlying processes that lead to TBM. The treatment option that is right for you depends on how severe your condition is.

More about TBM

 

TBM cough before treatment

TBM cough after treatment

 

Diagnosis

Other lung conditions, such as asthma, COPD, or emphysema, can cause symptoms that are similar to TBM. To ensure an accurate diagnosis, we offer patients one-stop access to a multidisciplinary team of experts.

Our specialists will first ask about your symptoms and past health problems, and do a thorough physical exam. They may also ask you to undergo two specialized medical tests — a dynamic flexible bronchoscopy and a dynamic expiratory CT scan — to determine whether you have TBM — and if so, how severe it is.

Dynamic Expiratory CT Scan (Computed Tomography Scan)

During a CT scan, you lie very still on a table while multiple x-rays are taken 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 a doctor to look into your airways. This is the gold standard for diagnosing TBM because it permits real-time examination of the airways while you breathe. It also provides information on the extent and location of airway collapse.