TBM management will depend on its severity. Sometimes medical treatment options will be recommended; sometimes your doctor will decide that surgery is the best route.
Some medical treatments include:
- Conservative medical management, like nightly use of a continuous positive airway pressure (CPAP) machine
- This acts as a pneumatic (air pressure) stent, and should be considered as an alternative or additional therapy in appropriate patients
- Inhaled bronchodilators (these should only be used if symptoms and breathing function improve after use)
Surgical treatments may include:
- Silicone and/or long-term stenting
- Inserting a stent can improve symptoms and pulmonary function in patients with central airway obstruction and should be considered for patients whose symptoms don’t respond to more conservative therapy
- Surgical correction
- Tracheoplasty can be performed in a subset of patients to stabilize the airway by reinforcing the back wall of the windpipe with a mesh to prevent its collapse
At the Temple Lung Center, a multidisciplinary medical team is led by specialty-trained thoracic surgeons. This team also includes pulmonologists, radiologists, sleep specialists, and digestive disease physicians. Management of TBM is usually conservative at first, using inhalers, CPAP, or mucolytics (dissolving thick mucus) and antibiotics when indicated. However, if surgery is indicated, the team performs tracheobronchial stenting or surgical stabilization of the airway by posterior splinting.