Normal tracheal dynamics include a small caliber change with respiration and one-half or less diameter collapse with coughing in the anteroposterior and oblique positions. In ciné studies of 35 patients, increased collapsibility caused by tracheomalacia is associated with increased symptomatology in the respiratory system, particularly with progressive severity of bronchitis and emphysema. Swallowing difficulties are related to flapping of the esophagus during coughing. The common etiology appears to be inhalation of chronic irritants such as cigarette smoke and industrial air pollutants. Other factors, such as infection, trauma, and neoplasms have been implicated. Localized tracheomalacia occurs postsurgically with tracheostomy and placement of endotracheal tubes, as well as idiopathically.
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Johnson et al. (1973) studied this question.