From the Guidelines
A deviated trachea means the windpipe (trachea) has shifted from its normal central position in the neck, often due to underlying conditions such as masses, collapsed lung, or structural abnormalities. This deviation can be caused by various factors, including masses in the neck or chest, such as tumors or enlarged lymph nodes, pleural effusion, trauma, or structural weaknesses like tracheomalacia, which is characterized by the loss of cartilaginous integrity of the airway walls 1. The trachea normally runs straight down the middle of the neck and chest, but when deviated, it may bend or move to one side.
Key Points to Consider
- A deviated trachea is not a disease itself but rather a sign of an underlying condition that requires medical evaluation to determine the cause.
- Symptoms may include difficulty breathing, abnormal sounds when breathing, or cough, though some people with a deviated trachea have no symptoms at all.
- The treatment focuses on addressing the underlying cause rather than the tracheal deviation itself, and it is crucial to identify and manage conditions like tracheomalacia, which can cause significant narrowing of the airway diameter during forced expiration or cough 1.
- Imaging studies like chest X-rays or CT scans are typically used to discover and assess the extent of tracheal deviation.
- Conditions such as tracheobronchomalacia in adults can be caused by or associated with pressure necrosis of the cartilage due to endotracheal intubation, thyroid lesions, vascular anomalies, or trauma, highlighting the importance of considering a broad range of potential causes when evaluating a deviated trachea 1.
From the Research
Definition and Causes of Deviated Trachea
- A deviated trachea, also known as tracheal deviation, refers to an abnormal displacement or curvature of the trachea (windpipe) from its normal position 2, 3, 4.
- This condition can be caused by various factors, including anatomical abnormalities, tumors, or other pathologies that affect the trachea and surrounding structures 5, 6, 4.
Characteristics and Associated Risks
- A deviated trachea can lead to difficulties in airway management, particularly during intubation and ventilation 2, 5.
- The condition can also increase the risk of complications, such as massive aortic hemorrhage and postoperative trachea-brachiocephalic artery fistula 2.
- Tracheal deviation can be associated with other conditions, including tracheal narrowing, which can lead to respiratory symptoms and life-threatening airway obstruction 5, 4.
Diagnosis and Evaluation
- Computed tomography (CT) angiography can be used to evaluate tracheal abnormalities, including deviation, narrowing, and shape 4.
- The location and course of surrounding vasculature, bones, and thyroid gland can also be assessed to understand the interplay between these structures and the trachea 4.
Clinical Implications
- A deviated trachea can have significant clinical implications, particularly in patients with underlying conditions, such as mucopolysaccharidosis type IVA (MPS IVA) 4.
- Understanding the characteristics and associated risks of tracheal deviation is essential for developing effective airway management plans and minimizing the risk of complications 2, 5, 4.