Tracheobronchiomegaly

Abstract

Tracheobronchiomegaly is a condition of abnormal, probably congenital, enlargement of the trachea, main bronchi, and segmental bronchi. In addition, it is characterized usually by diverticula and sacculations between the cartilaginous rings. As an aid to diagnosis, the authors measured the transverse and anterior-posterior diameters of the trachea and main bronchi at autopsy of 100 men to determine the normal limits. Transverse diameters of the trachea greater than 25 mm, of the right main bronchus greater than 23 mm, and of the left main bronchus greater than 20 mm should raise the suspicion of tracheobronchiomegaly. The diagnosis can be strengthened if bronchographic abnormalities such as sacculations or unusual deformity are found. In using bronchographic measurements, a correction for the slight magnification that results from this technique must be made. Diagnosis also depends on clinical features such as a whooping, chronic cough, poor ability to raise secretions, and repeated episodes of bronchitis and pneumonitis. A routine chest roentgenogram may show a widened tracheal air column. Therapy should include vigorous use of antibiotics and postural drainage.