Dynamic computed tomography in the diagnosis of tracheomalacia in asthmatic patients

Dynamic computed tomography (CT) offers a non-invasive approach to diagnosing tracheomalacia, especially in asthmatic patients with varying severities of airway obstruction. This study aimed to assess the incidence of tracheomalacia in asthmatic patients using dynamic CT and its relation to asthma severity. A total of 60 asthmatic individuals, diagnosed based on the Global Initiative for Asthma 2021 criteria, participated in this cross-sectional study. Participants were split into three separate groups (mild, moderate, and severe) based on pre-bronchodilator forced expiratory volume levels. All patients underwent dynamic CT to evaluate tracheal collapsibility, and spirometry was performed to assess pulmonary function. Tracheomalacia was detected in 5 participants (8.3%). The groups showed a significant disparity in pre- and post-forced expiratory volume % (p<0.001) and the forced expiratory volume/forced vital capacity ratio (p<0.001). Additionally, the bifurcation cross-sectional area % expiration/inspiration was significantly lower in the tracheomalacia group (p<0.001), and the aorta cross-sectional area % expiration/inspiration also reported a significant reduction (p<0.001). Dynamic CT is a valuable diagnostic tool for identifying tracheomalacia in asthmatic patients. Although tracheomalacia was not directly related to asthma severity, further studies are needed to explore its potential causes, including airway remodeling and gastroesophageal reflux disease.