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Background : Rabbits have long been used as experimental models for tracheal disease, but very little information has been published about the diagnosis and management of naturally occurring pathology in this species. Case Description : A 7-year-old rabbit with concurrent upper respiratory disease was diagnosed with tracheal collapse using diagnostic imaging and tracheoscopy. Tracheal resection and anastomosis was performed to remove the affected area and produced resolution of clinical signs for approximately 6 months. The patient's signs eventually returned due to development of granulation tissue at the anastomosis site. Debridement, application of topical medications, and removal of suture material were ultimately unsuccessful in resolving the patient's respiratory distress, and the rabbit was euthanized 10 days later. Conclusions & Case Relevance : Based on the outcome of this case, tracheal resection may provide temporary relief from clinical signs of tracheal collapse in rabbits, but further research is required to determine which surgical techniques provide the best outcome and to better define contraindications. [ABSTRACT FROM AUTHOR]

Abstract Objective Suprastomal collapse is a complication of pediatric tracheotomy with a potential impact on decannulation success. The aim of this study was to review the experience in the management of pediatric suprastomal collapse in a tertiary-care center, detailing the surgical technique employed. Methods This study included 12 tracheotomised children with the diagnosis of suprastomal collapse in the last 5 years. All patients of the study underwent surgical intervention to manage suprastomal collapse to achieve tracheotomy decannulation. The surgical procedure entailed dissection of the pre-existing tracheotomy tract down to the trachea, then excision of the tract flush with the anterior tracheal wall. The tracheal opening was closed transversely with 3–4 interrupted absorbable sutures placed in craniocaudal direction. Results At the end of treatment all patients were decannulated successfully. No intraoperative complications were reported. Minor postoperative complications were reported in 3 children in the form of mild surgical emphysema (n = 2) and wound infection (n = 1). Those patients were successfully managed conservatively. Conclusion This technique is a simple and effective procedure enabling immediate decannulation with very low morbidity. In a long term follow up period, no recurrence has been reported and all patients returned to their usual quality of life. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: The opened or closed status of the glottis might influence tracheal size changes in inspiratory and expiratory computed tomography (CT) scans. We investigated if the glottis status makes the tracheal collapse differently correlate with lung volume difference between inspiratory and expiratory CT scans.Materials and Methods: Forty patients with chronic obstructive pulmonary disease whose glottis was included in the acquired scanned volume for lung CT were divided into two groups: 16 patients with the glottis closed in both inspiratory and expiratory CT, and 24 patients with the glottis open in at least one CT acquisition. Lung inspiratory (Vinsp) and expiratory (Vexp) volumes were automatically computed and lung ΔV was calculated using the following formula: (Vinsp - Vexp)/Vinsp × 100. Two radiologists manually measured the anteroposterior diameter and cross-sectional area of the trachea 1 cm above the aortic arch and 1 cm above the carina. Tracheal collapse was then calculated and correlated with lung ΔV.Results: In the 40 patients, the correlations between tracheal Δanteroposterior diameter and Δcross-sectional area at each level and lung ΔV ranged between 0.68 and 0.74 (ρ) at Spearman rank correlation test. However, in the closed glottis group, the correlations were higher for all measures at the two levels (ρ range: 0.84-0.90), whereas in the open glottis group, correlations were low and not statistically significant (ρ range: 0.29-0.34) at the upper level, and moderate at the lower level (ρ range: 0.51-0.55).Conclusions: A closed or open glottis influences the tracheal size change in inspiratory and expiratory CT scans. With closed glottis, the tracheal collapse shows a stronger correlation with the lung volume difference between inspiratory and expiratory CT scans. [ABSTRACT FROM AUTHOR]

Dogs with tracheal collapse may present with life-threatening upper airway obstruction. In most instances, a conservative approach to treatment including oxygen support coupled with sedation and cooling measures will relieve respiratory effort and thus relieve airway obstruction. Dogs that fail this conservative approach require endotracheal intubation to ensure a patent airway. This population of patients would benefit from a more definitive, yet palliative treatment option to acutely relieve upper airway obstruction. Placement of a self-expanding metallic stent that spans the affected portion of the trachea will acutely provide the patient with a sustained patent airway and optimize the likelihood of a positive outcome. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: To retrospectively investigate the prevalence of tracheal collapse in an emphysema cohort. The occurrence of a large degree of tracheal collapse may have important implications for the clinical management of respiratory symptoms and air trapping in patients with emphysema. Materials and Methods: Paired full-inspiratory and end-expiratory thin-section volumetric computed tomographic scans were available for 1071 long-term smokers with clinically and physiologically confirmed emphysema. The percentage reduction in the cross-sectional tracheal luminal area from full-inspiration to end-expiration was automatically computed at 2.5-mm intervals along the centerline of the trachea using customized software. Results: Maximal tracheal collapse did not follow a normal distribution in the emphysema cohort (P < .0001, skewness/kurtosis tests for normality); the median collapse was 18% (intraquartile range, 11%–30%). Statistically significant differences were found in the distribution of maximal collapse by gender (P < .005, Wilcoxon rank sum test). Overall, 10.5% of men and 17.1% of women showed evidence of tracheomalacia on the basis of the criterion of a reduction of 50% or greater in cross-sectional tracheal luminal area at end-expiration. Conclusion: This study offers insights into the prevalence of tracheal collapse in a cohort of patients with emphysema; future work is needed to determine the possible relationship between tracheal collapse and air trapping in subjects with emphysema. [Copyright &y& Elsevier]

Tracheal collapse in dogs is a common respiratory disorder, typically presenting with a history of chronic cough, increasing respiratory difficulties, and episodes of dyspnoea. Medical treatment is the therapy of choice and surgical repair is considered when patients do not respond well. Minimally invasive endotracheal stenting is a promising new therapy under investigation, but there remain significant challenges to overcome potential complications. The purpose of this article is to provide a comparative overview of intra-luminal stenting of the trachea in human and veterinary medicine. The currently available stents and their potential clinical application to the veterinary patient will be discussed. [ABSTRACT FROM AUTHOR]

Loss-of-function mutations in the COL2A1 gene were previously described as a cause of type II collagenopathy (e.g. , spondyloepiphyseal dysplasia, Stickler syndrome type I), a major subgroup of genetic skeletal diseases. However, the pathogenic mechanisms associated with COL2A1 mutations remain unclear, and there are few large-mammal models of these diseases. In this study, we established a swine model carrying COL2A1 mutations using CRISPR/Cas9 and somatic cell nuclear transfer technologies. Animals mutant for COL2A1 exhibited severe skeletal dysplasia characterized by shortened long bones, abnormal vertebrae, depressed nasal bridge, and cleft palate. Importantly, COL2A1 mutant piglets suffered tracheal collapse, which was almost certainly the cause of their death shortly after birth. In conclusion, we have demonstrated for the first time that overt and striking skeletal dysplasia occurring in human patients can be recapitulated in large transgenic mammals. This model underscores the importance of employing large animals as models to investigate the pathogenesis and potential therapeutics of skeletal diseases. Unlabelled Image • CRISPR/Cas9 and SCNT enable the generation of COL2A1 -modified pigs • COL2A1 mutant piglets exhibit evidently undeveloped tissue of cartilage and bone • Tracheal collapse is found in the COL2A1 mutant piglets • Type II collagen is decreased in the articular cartilage of COL2A1 mutant piglets [ABSTRACT FROM AUTHOR]