[Comparative cinematographic, endoscopic and functional analytic studies of the pre- and postoperative evaluation of the severity of the tracheobronchial collapse syndrome].

Sixty eight adults of both sexes (33 patients with clinically and endoscopically verified tracheobronchial collapse; 35 persons without disease of the central airways) underwent continuous cinetracheographic studies of the wall-movements of the central airways during various respiratory maneuvers. The insufflation of powdered tantalum for a better outlining of the contours of the central airways was preferably done in local anaesthesia via an orotracheally inserted catheter. Studies of wall-movement were made in recumbent position during forced breathing and violent coughing in various obliquities using a 35 mm-camera. The percentage of diameter-shortening during expiration (forced breathing; violent coughing) in relation to the inspiratory diameter during the same breathing-maneuver was measured in 4 or 3 projections respectively at 5 localities (cervical trachea; thoracic outlet; thoracic trachea 1 cm above the bifurcation; right and left main bronchus, 1 cm distant from bifurcation). Out of maximally 17 single numerical values per examination the highest single value was selected as the so-called "maximal relative diameter-shortening" - independent of locality and projection. In healthy persons the mean value amounts to 22.4 +/- 15.44% (means +/- SD) during forced breathing and to 75.5 +/- 11.72% during violent coughing. Patients with a tracheobronchial collapse differ from healthy persons, the former having a value of 100% during violent coughing. This is equivalent to a brief contact of the membranous part to the ventral circumference of the trachea (total cough-collapse) at least at one locality in one projection. Out of a number of 28 patients 17 cases (group H) revealed a normal "maximal relative diameter-shortening" of 29.7 +/- 21.57% during forced breathing. In addition to the total cough-collapse 11 patients (group F) exhibited an increased prolapse-tendency of the membranous part during forced breathing, too; the mean value of the "maximal relative diameter-shortening" amounted to 80.5 +/- 16.15%. Pathological shortening-values are mainly measured at the intrathoracic trachea in the lateral and both oblique projections. The cinetracheobronchographic examination should be used in patients with endoscopic signs of a tracheobronchial collapse-syndrome if an operative procedure with tautening is taken into consideration. In the case of mere clinical suspicion of the presence of a collapse-syndrome the assessment of the wall-motility is non-invasively possible by means of cinetracheography without a contrast-agent.(ABSTRACT TRUNCATED AT 400 WORDS)