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Dynamic CT Evaluation of the Central Airways in Patients Undergoing Tracheoplasty for Tracheobronchomalacia

¹ Instituto de Radiologia, Hospital das Clinicas da Faculdade de Medicina da USP, São Paulo, Brazil.
² Instituto Israelita de Ensino e Pesquisa Albert Einstein, Department of Radiology, Albert Einstein Hospital, São Paulo, Brazil.
³ Department of Cardiothoracic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215.
⁴ Department of Radiology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.

OBJECTIVE. The objective of this study was to describe the role of pre- and postoperative dynamic CT in patients undergoing tracheoplasty, a novel surgical method for treatment of severely symptomatic tracheobronchomalacia.

CONCLUSION. Five patients were referred for dynamic MDCT before and after undergoing tracheoplasty at our institution. Preoperatively, all patients showed signs of tracheobronchomalacia ( 50% airway collapse) on bronchoscopy, and four (80%) of these five patients showed evidence of malacia on dynamic forceful expiratory CT scans. In all five cases, postoperative CT showed a reduction in the degree of airway collapse during expiration, changes in shape of the trachea during inspiration, and posterior wall thickening related to the procedure. Our preliminary results suggest a potentially important role for CT in the pre- and postoperative assessments of patients with tracheobronchomalacia referred for tracheoplasty.

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