Respiratory Disorders Expert Forum
bronchomalacia
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bronchomalacia

I am 41 years old female (light smoker)I started coughing up blood, my Doctor performed a brochoscopy and found my right lung had collapsed. I was soon diagnosed with bronchomalacia, I need huge amount of prednesone to breath. First,  all of the research I've done states this condition is found in children??? secondly, Can you tell me the pros and cons on having stents placed in me. Third what can I do to prevent having the stents.

Thank you for your time and knowledge.

Kimberly Attkisson
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In babies rings of cartilage keep the trachea open so that air can get from the throat to the lungs.  When these rings are small, shaped oddly, not stiff enough, or do not form at all then the trachea can close in on itself.  This is more likely to happen while exhaling and crying.  This may cause wheezing, coughing, shortness of breath, and/or fast breathing.  Usually the cartilage develops by itself over time so that tracheomalacia is no longer a problem.  While more common in infants, tracheomalacia does occur in adults.

When this same problem happens in the smaller airway called a bronchus it is called bronchomalacia.  The airways of the lungs narrow or collapse while exhaling because of softening of the airway walls.  It is possible that the air will not be able to reach the airsacs that are at the end of that airway.  Attempts should be made to find the cause of your bronchomalacia.

One major cause of bronchomalacia is a rare disease called relapsing polychondritis (RP).  This reoccurring problem causes the connective tissue to become inflamed.  Connective tissue is any tissue made of cartilage.  It can be found in the trachea, nose, larynx, kidneys, joints, heart valves, eyes, ears, and blood vessels.  When it effects the airways of the lungs this may cause problems typical of asthma.  Initially with RP the airway collapse is due to airway inflammation rather than damage to cartilage.  Treatment of RP with immunosuppressive medicines, including prednisone, may delay or prevent permanent damage to cartilage.

Most of the surgery to treat bronchomalacia has been done in babies and children.  However this surgery has also been done in adults.  Surgery is used to place a stent in the airways that are collapsing.  A stent is a device that keeps the airways open.  A chest surgeon who has had experience with this type of surgery will be able to arrange for this treatment.  This stenting surgery has been done at the Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Ohio.

In bronchomalacia the airways of the lungs narrow or collapse while exhaling because of softening of the airway walls.  A technique that may prevent you from having the stents is to "splint" the airways so they stay open rather than collapsing.  Increasing the pressure in your airways while you are exhaling provides this
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