What is Tracheal Deviation and how to deal with it?

If you have ever heard a doctor refer to your trachea as your “windpipe,” that term probably made it sounds like the trachea was some kind of internal tube, simple and sturdy.

But as WebMD outlines, the trachea is more complex than its simple name would suggest.(1)

For such a short length of the tube (just four to six inches from end to end and one inch across in adults), there is quite a bit going on inside. When any aspect of your trachea ceases to function correctly, the whole system can grind to a halt.

As the word “deviation” suggests, when a tracheal deviation occurs, it means the trachea itself is no longer situated correctly within the throat and upper chest cavity.

This can happen for a wide variety of reasons.

In this article, learn more about this health issue, warning signs and symptoms, how it is diagnosed and what treatments are available.

 

What Is Tracheal Deviation?

To fully understand what it is, first it can help to understand where the trachea is location and its component parts.

Interestingly, Britannica points out that every living being – vertebrate (with spine) and invertebrate (without spine) has some form of trachea – it is just that essential for respiration!(2)

As Medline Plus explains, the trachea is the tube that connects your larynx (voice box) with your lungs.(3)

Every time you inhale, you rely on the trachea to deliver that fresh oxygen-rich air to your lungs.

The trachea uses two smaller tubes called bronchi to deliver air to the lungs. The lungs will then exhale and give the trachea the waste matter carbon dioxide to carry back up and dispose of through your nose and mouth.

In order for this whole process to work as it is designed to do, the trachea needs to maintain a certain position in relation to the larynx and the bronchi.

When the trachea moves, or deviates, from that ideal position, this is called a “tracheal deviation.”

 

Causes

This condition can occur for a number of reasons. One of the most common reasons is the simple development of the respiratory system.

For this reason, if the tracheal deviation is found in infants and children up to the age of five years old, typically doctors find it to be no cause for concern. As the entire internal system develops and stabilizes and the neck grows longer, the trachea will find its proper place on its own.

However, when this problem occurs in children older than five years (as in a sudden onset after the age of five) or in tweens, teens or adults, typically there is another underlying reason that has prompted the shift.

According to iHealthBlogger, here are the best-known causes, in older children and adults:(4)

» Atelectasis. This is the medical term for “collapsed lung.” When one of the lungs deflates for any reason (for example, blockage or puncture), the trachea is moved out of its normal position.

» Pneumonectomy. A pneumonectomy is sometimes prescribed to treat lung cancer. Here, a partial or full removal of a lung may cause the trachea to be displaced.

» Pleural Fibrosis. The inner lining of the chest cavity is called the pleura. When the pleura becomes inflamed, it can thicken and even harden and calcify, which can put pressure on the systems within and cause this issue.

» Pleural Effusion. When fluid begins to collect and build up in the pleural space, which is the open area between the lungs and the inner wall of the chest, this is called pleural effusion. Minor amounts of fluid buildup will not cause a tracheal deviation, but when the fluid amount grows, it can throw the trachea out of position.

» Pneumothorax. Often considered the most immediately life-threatening of all the possible causes for tracheal deviation, pneumothorax, or lung injury, can clearly be deadly in its own right. Here, most or all of the major nearby systems will be impacted, from the heart to the trachea and more.

» Tumor growth. Sometimes tumors begin to grow inside the chest cavity. The tumor may be benign or malignant, but if it begins to take up space to the point where other systems have to compete for space, the trachea can be displaced.

» Lung aplasia/agenesis. This hereditary condition may cause an infant to be born with only one lung or missing bronchi.

» Retrosternal goiter. When the thyroid gland begins to enlarge beyond its normal size, this can put pressure on the larynx and then the trachea, causing deviation.

» Lymphoma. Often a precursor to cancer, when the lymph nodes in the neck region begin to swell, this can push the larynx and the trachea out of position.

 

Symptoms

As Right Diagnosis points out, the symptoms can vary depending on the underlying cause.(5)

For this reason, keeping a symptoms log can be extremely helpful in reaching the right diagnosis as quickly as possible so you can begin to receive treatment.

Here are the most commonly reported basic patient symptoms, as described by Health Tool: (6)

» Breathing difficulty.
» Gasping or wheezing.
» Shortness of breath.
» Respiratory arrest.
» Chest pain.
» Anxiety.
» Feelings of fatigue or weakness.
» Increase in heart rate.
» Decreased blood pressure.
» Swollen jugular vein (major vein in your neck).
» Coughing.
» Absence of the typical sounds of breathing.

 

Diagnosing

While determining the root underlying cause may take some time, diagnosing a tracheal deviation itself is relatively easy to accomplish.

As Radiology Masterclass explains, the key to an accurate diagnosis is to ensure the patient is positioned properly during the examination and testing process. Otherwise, the results may be skewed.(7)

You should bring your symptoms log to your examination to facilitate the diagnostic process.

Your physician will listen to your breathing and will likely palpate your neck and chest region. Sometimes it is possible to manually feel a tracheal deviation via palpation.

» Chest X-ray. For a definitive diagnosis, however, your physician will likely order a chest X-ray. This test will give your doctor a visual image of what is going on inside your chest region, including abnormal growths that may be causing the trachea to be pushed to one side or the other. However, as eMedicine Medscape points out, if the trachea is being pushed forward or back, this may not be as easy to detect on a chest X-ray.(8)

» CT scan. Another test commonly prescribed is a CT scan, which can give your doctor more detail about what is displacing your trachea and will also look for signs of lung or chest trauma such as a fractured or broken rib that has punctured a lung.

 

Treatment

Since this health issue can cause respiratory arrest, the first line of treatment is often critical care to restore respiration, stabilize heart rate and blood pressure and ensure the patient is sufficiently medically stable to finish the diagnostic process and begin treatment in earnest.

Treating often focuses on resolving the underlying issue, whether it is a growth or mass in the chest area, chest or lung trauma, a surgical procedure that has caused chest imbalance (such as lung removal procedure) or a fluid buildup in the chest cavity.

As mentioned initially, if this condition is present in a child aged five or under, no treatment is typically ordered so long as there are no symptoms.

 

Conclusion

If you or someone you love has been having trouble with breathing and you suspect a tracheal deviation may be present, it is important not to delay scheduling a medical examination to discover what is causing the displacement.

Take these steps right away to find out what is causing your respiratory and other symptoms so you can get treated and start to feel better as soon as possible:

» Keep a symptoms log and bring it to your exam.
» Have any tests your doctor orders to achieve a definitive diagnosis.
» Proceed with your doctor’s recommended course of treatment.

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References

(1)”webmd.com/lung/picture-of-the-trachea#1

(2)”britannica.com/science/trachea

(3)”medlineplus.gov/trachealdisorders.html

(4)”ihealthblogger.com/tracheal-deviation-causes-and-treatment/

(5)”rightdiagnosis.com/symptoms/tracheal_deviation/symptom-search.htm

(6)”healthool.com/tracheal-deviation/

(7)”radiologymasterclass.co.uk/tutorials/chest/chest_pathology/chest_pathology_page1

(8)”emedicine.medscape.com/article/1909159-technique

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