Recognizing and Treating Tracheobronchomalacia

Program Goals

ILD CME

Tracheobronchomalacia (TBM) is an under-recognized cause of shortness of breath, recurrent respiratory infections and chronic coughing. It involves collapse of the main airways, due to a weakness of the cartilage and/or floppiness of the posterior membranous wall. Most cases of TBM are acquired, but the cause remains largely unknown, even though gastroesophageal reflux disease may be a contributing factor. Patients with TBM often have comorbidities, such as asthma or chronic obstructive pulmonary disease (COPD), making it harder to recognize airway collapse as a contributing factor to their symptoms. In fact, inappropriate treatment for these pulmonary conditions may precede eventual recognition of TBM by months or years.

Diagnosis of TBM is made by airway computed tomography scan and flexible bronchoscopy under conscious sedation. The management of TBM mainly involves optimization of medical therapy. Surgical stabilization of the airway by posterior splinting (tracheobronchoplasty) effectively and permanently corrects collapsed airways, in a carefully selected subset of patients with TBM. Proper surgical selection can be preceded by a short-term airway stent trial.

The activity will inform physicians and advanced practitioners about the importance of a multidisciplinary approach in the management of TBM, from diagnosis to treatment. We emphasize the need of reserving surgery to severely symptomatic patients who fail medical therapy, and the importance of objective long-term follow-up of this challenging condition.

Target Audience

Pulmonologists; Critical Care Specialists; Thoracic Surgeons, Radiologists, Internal Medicine and Primary Care Physicians; Physician Assistants; Advanced Practice Nurses; and Nurse Practitioners.

Learning Objectives

After the conclusion of this activity, participants should be able to:

  1. Summarize the prevalence of Excessive Central Airway collapse (ECAC) in patients with chronic respiratory conditions.
  2. Identify the indications for surgical intervention for tracheobronchomalacia (TBM) and Excessive Dynamic Airway Collapse (EDAC).
  3. Recognize the Imaging Strategies for diagnosis of TBM.
  4. List the challenges in dynamic Imaging for diagnosis of TBM.
  5. Describe the characteristic imaging features of TBM.
  6. Discuss the importance of multi-disciplinary approach in the management of ECAC.

Faculty

Charles Bakhos, MD, MBA, MS, FACS
Professor of Thoracic Medicine and Surgery
Lewis Katz School of Medicine at Temple University
Temple University Hospital

Maruti K. Kumaran, MD, FRCR
Associate Professor, Radiology
Lewis Katz School of Medicine at Temple University
Temple University Hospital

Educational Activity Agenda

Educational Presentation (52.5 minutes)
Post Test, Evaluation & Certificate delivery (15 minutes)
Total Activity: (67.5 minutes)

Release and Expiration Dates

Release Date: November 7, 2022
Expiration Date: November 7, 2024

Disclosure Policy

It is the policy of the Lewis Katz School of Medicine at Temple University, The Albert J. Finestone, M.D., Office for Continuing Medical Education that anyone in a position to control the content of a certified educational activity must disclose any financial relationships with ineligible companies within the prior 24 months. The Accreditation Council for Continuing Medical Education (ACCME) defines ineligible companies as “those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.” Speakers must also disclose discussions of unlabeled/ unapproved uses of drugs or devices during their presentations. The Lewis Katz School of Medicine at Temple University has policies in place that will identify and mitigate all conflicts of interest prior to the educational activity. Detailed disclosure will be communicated to learners prior to the activity.

Faculty Disclosures

The faculty disclosed the following financial relationships with ineligible companies related to the content of this educational activity. 

Charles Bakhos, MD, MBA, MS, FACS
• Nothing to disclose

Maruti K. Kumaran, MD, FRCR
• Nothing to disclose

None of the faculty for this educational activity have relevant financial relationships to disclose with ineligible companies.

Course Directors, Planners, Reviewers, and Managers/CME Staff Disclosures

The course directors, planners, reviewers, and managers/CME staff disclosed the following financial relationships with ineligible companies related to the content of this educational activity:

Charles Bakhos, MD, MBA, MS, FACS (Planner and Faculty)
• Nothing to disclose

Joseph Friedberg, MD, FACS (Reviewer)
• Nothing to disclose

Amanda Snider (Manager)
• Nothing to disclose

Arnold I. Meyer, Ed.D, FACEHP (Planner and CME Staff)
• Nothing to disclose

Katrina Ilagan (CME Staff) 
• Nothing to disclose

*None of the course directors, planners, reviewers, and managers/CME staff for this educational activity have relevant financial relationships to disclose with ineligible companies. 

Accreditation Statement

Temple University Lewis Katz School of Medicine

Lewis Katz School of Medicine at Temple University is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide Continuing Medical Education for physicians.

Certification Statement

Lewis Katz School of Medicine at Temple University designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

How to Obtain CME Credit

Attendees are expected to view all presentations before attempting to take the test and/or complete the activity evaluation. Successful completion will lead to the issuance of a certificate for AMA PRA Category 1 Credit(s)™.  To receive credit, the course must be completed between November 7, 2022 - November 7, 2024. 

Participation in this activity should be completed in approximately 1.0 hour(s). Please follow these steps in order to receive CME/CE credit for viewing the webcast:

• Read all of the CME/CE accreditation information above.
• View the complete electronic (web) activity.
• Click on the link to apply for CME/CE credits.
• Complete the online registration (registration is free).
• Complete the online test and/or evaluation. Participants must receive a test score of at least 75% and answer all evaluation questions to receive a certificate.

After successfully completing the online test and/or evaluation, your application will be immediately processed, and you will be given the opportunity to download a personalized CME/CE certificate for participation in this activity.

Should you have any CME questions regarding this activity, please contact:

The Albert J. Finestone, MD Office for Continuing Medical Education
Lewis Katz School of Medicine at Temple University
3500 North Broad Street
11th Floor MERB, Room 1111S
Philadelphia, PA 19140
Main CME Phone:  215-707-4787
Fax:  215-707-8268

No commercial support has been provided for this activity.

 

System Requirements

To view this educational activity you, will need a web browser with JavaScript and either Flash or HTML5 enabled.  Nearly all modern web browsers will work. 

  If you have special accommodations that we can address to make your participation more meaningful and enjoyable, please contact our office at (215) 707-4787 or cme@temple.edu.

Copyright

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