Tracheal deviation happens when your trachea is pushed to one side of your neck by abnormal pressure in your chest cavity or neck.
The trachea, also known as your windpipe, is a tube made of cartilage that allows air to pass in and out of the lungs as you breathe. Normally, the trachea runs right down the middle of your throat behind your larynx. But when pressure builds up in your chest cavity, your trachea can get pushed to one side of your throat wherever pressure is lower. An injury that causes a lot of swelling or internal bleeding in the neck can create enough pressure to deviate the trachea.
Tracheal deviation is a symptom of:
- certain chest, neck, and lung conditions
- chest injuries
- conditions exacerbated by smoking or other sources of toxic air
- neck injury causing swelling or bleeding inside the neck
In some cases, it can be caused by the pressure pregnancy exerts on your body.
What causes tracheal deviation?
Tracheal deviation is most commonly caused by injuries or conditions that cause pressure to build up in your chest cavity or neck. Openings or punctures in the chest wall, the lungs, or other parts of your pleural cavity can cause air to only move in one direction inward.
Pneumothorax is the most frequently reported cause of tracheal deviation from pressure buildup. This condition happens when excess air builds up in your chest cavity and can’t escape. It’s also known as a collapsed lung.
The growth of cancerous tumors, lymph nodes, and glands can also create pressure in your chest.
Other possible causes include:
This is an enlargement of the thyroid gland near the base of the neck. It’s close to your windpipe, so if it grows, it can push the trachea to one side.
Mediastinal lymphoma is a type of cancer that affects the mediastinal lymph nodes. These are located near your trachea.
Pleural effusion is a condition in which extra fluid builds up around the lungs in the pleural cavity.
Pneumonectomy is a type of lung removal surgery. It can cause pressure to be unevenly distributed throughout your chest cavity.
This is a condition where only part of a lung has collapsed. It’s usually caused when sacs of air in the lungs, called alveoli, can’t hold air. This creates uneven pressure in the chest cavity, which can cause the trachea to move.
This condition happens when the membrane that surrounds the lungs, known as the pleura, becomes inflamed.
Pulmonary fibrosis happens when your lung tissue is scarred. The lungs can become stiff and create abnormal pressure in your chest cavity.
Tracheal deviation is normal for many young children. It shouldn’t cause any concern. If your doctor finds a tracheal deviation in your child, they may not recommend any further treatment unless your child has other abnormal symptoms.
What are the symptoms of a tracheal deviation?
When the trachea deviates from its normal position, air can’t pass through it as easily. This can lead to the following symptoms:
- trouble breathing
- wheezing or other unusual breathing noises
- pain in your chest
Symptoms are largely the same in both children and adults.
How is tracheal deviation diagnosed?
An X-ray imaging test can show a deviated trachea. This can be done in a few hours and may provide a starting point for your doctor to look for underlying conditions.
Other tests that can help your doctor diagnose a condition that causes tracheal deviation include:
- Blood tests. Your doctor takes a sample of blood and sends it to a laboratory for analysis. The presence of certain antibodies or other substances can indicate a condition.
- Chest MRI. An MRI test uses magnets to create a cross-section image of your body. This can indicate the presence of a mass or other causes of chest pressure.
- CT scan. A CT scan is another imaging test that uses X-rays to create a cross-section image of your body.
- Thoracentesis. Your doctor inserts a needle into your ribs to remove fluid from your chest. A biopsy may then be done to test the fluid.
How is tracheal deviation treated?
Treatment for tracheal deviation depends on what condition is causing it:
Your doctor will likely surgically remove the goiter. You may receive iodine therapy to shrink the goiter if it’s not a serious case.
Chemotherapy may be necessary to kill cancer cells.
Thoracentesis can remove built-up fluid and relieve pressure. It also allows your doctor to perform a biopsy. Surgery may also be necessary.
Pressure buildup can usually be relieved with thoracentesis. Other complications from surgery, such as an infection, may need to be treated with antibiotics.
Deep breathing exercises can help you increase the amount of air you breathe in. Surgery may be recommended to clear any tissue blocking your airways.
Surgery may be done to remove parts of the pleura that are inflamed.
Medications, such as nintedanib (Ofev) and pirfenidone (Esbriet), may slow or keep the condition from progressing. Exercise and breathing techniques can help you breathe better, too.
Treatment depends on the cause. If bleeding is the cause, a surgical procedure to stop the bleeding and remove the blood from the tissue relieves the pressure. Swelling usually resolves with time. The concern here is making sure that breathing isn’t a problem.
Tracheal deviation may not need to be treated if it’s found in a young child with no other symptoms or complications.
What’s recovery from tracheal deviation like?
Recovery from treatment for a condition causing tracheal deviation can be quick. You can usually go home in a day or two after a thoracentesis or other fluid-drainage procedure.
Recovery from surgery may take a little longer. Depending on how severe your condition is, you may need to recover in the hospital anywhere from 2 to 10 days.
Some conditions, such as pulmonary fibrosis, can’t be fully cured. Medications may help slow the condition, but they won’t make symptoms go away completely. Recovery from the effects of this condition can take years.
What’s the outlook?
Chest pressure that causes tracheal deviation should prompt an immediate trip to your doctor. Once your doctor diagnoses the source of the deviation, treatment can usually start right away to minimize your symptoms.
In many cases, the condition is successfully treated. Depending on the severity of the condition, you’ll recover quickly with follow-up care, breathing exercises, medications, and more.