Last reviewed by Dr. Raj MD on January 12th, 2022.
What is tracheal deviation?
The trachea is another name for your windpipe and is an important structure that is used to help you breath. The trachea is a tube that is approximately four to six inches long and about one inch in diameter in an adult. It is located in front of your esophagus and almost in the middle of your neck. It is also what acts as a line of defense whenever you are exposed to certain irritants from the environment. On the inside of your trachea there is a mucous membrane that lines it that is sensitive and will stimulate the coughing reflex to get rid of any foreign bodies that have entered your trachea. It is part of your respiratory system.
When a person has tracheal deviation it means that your trachea has shifted more toward the right or left side instead of staying in the middle. In infants up to children that are five years of age tracheal deviation is a condition that is no clinical concern because it is usually not linked to any particular medication condition. The reason is that because of their short neck in comparison to the actual length of the trachea it will normally resolve on its own and will soon be outgrown as the child grows taller and their neck becomes longer.
Tracheal Deviation Symptoms
The symptoms of tracheal deviation are divided into several categories with each category having different symptoms.
- Respiratory arrest or distress
- Tachypnea – this is an increase in your respiratory rate
- Asymmetry in your lung expansion
- Decrease or absence of breath sounds
- Adventitious breath sounds which means hearing any crackles or wheezes
- Dyspnea which is difficulty with breathing
- Tachycardia which is an increase in your cardiac rate
- Hypotension which is a decrease in blood pressure
- Having a distention of your jugular vein but this is not always present especially if there is severe hypotension present
- Chest pain
Causes for Tracheal Deviation
There are many different things that can cause a person to have tracheal deviation.
- Tumors either malignant or benign found on your bronchi, pleural cavity, or lung(s)
- Pleural effusion – this is a medical condition where there is an accumulation of fluid between your lungs and chest wall.
- Pneumothorax – this is when you have an injury to your lungs. You may have your lungs collapse because of a large volume of air entering into the space between your lungs and chest wall called the pleural space. The air will compress and restrict the expansion of your lungs when you inhale.
- Pleural fibrosis – this is when the lining inside your chest cavity called the pleura thickens as a result of chronic inflammation and becomes calcified.
- Pneumonectomy – this is a procedure that is done to treat lung cancer by surgically removing all or partially your lung.
- Atelectasis – this is the medical term for collapsed lung which could happen to a blockage or obstruction that keeps it from being to sufficiently inflate.
- Lung aplasia/agenesis – this is a congenital abnormality where there is an absence of your lung and/or the bronchus.
- Retrosternal goiter – this is an enlargement of your thyroid gland or having a portion of your thyroid gland lying behind your sternum.
- Lymphoma or other causes of having extremely swollen lymph nodes in your neck
- Lung cancer
It is easy to diagnosis tracheal deviation by grossly examining it. Your physician can also palpitate it to feel where your trachea is located to see if it is the right place. The physician will also look at your symptoms and if you are having a cough, difficulty breathing, or abnormal breath sounds these are a good indicator that you could have tracheal deviation. To make the right diagnosis your physician will have an x-ray taken.
If you are diagnosed with tracheal deviation your physician will need to find out what the underlying cause is before treatment can be started because each cause is treated in a different way.