Paudyal V, Thapa R, Itani A, Sharma M, Rayamajhi R, Ratnani I, Surani S. Excessive dynamic airway collapse: A condition behind the veil. World J Methodol 2026; 16(1): 108381 [DOI: 10.5662/wjm.v16.i1.108381]
Corresponding Author of This Article
Salim Surani, MD, Professor, Department of Medicine and Pharmacology, Texas A&M University, College Station, 40 Bizzell Street, Laredo, TX 77843, United States. srsurani@hotmail.com
Research Domain of This Article
Medicine, General & Internal
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Minireviews
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Mar 20, 2026 (publication date) through Feb 13, 2026
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Publication Name
World Journal of Methodology
ISSN
2222-0682
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Paudyal V, Thapa R, Itani A, Sharma M, Rayamajhi R, Ratnani I, Surani S. Excessive dynamic airway collapse: A condition behind the veil. World J Methodol 2026; 16(1): 108381 [DOI: 10.5662/wjm.v16.i1.108381]
Vivek Paudyal, Rubi Thapa, Department of General Practice and Emergency Medicine, Karnali Academy of Health Science, Jumla 21200, Nepal
Asmita Itani, Department of General Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu 44600, Nepal
Munish Sharma, Department of Pulmonary and Critical Care Medicine, Baylor Scott and White, Temple, LA 76508, United States
Rabindra Rayamajhi, Department of Medicine, Baylor Scott and White, Temple, TX 76508, United States
Iqbal Ratnani, Department of Anesthesiology, Houston Methodist, Houston, TX 77030, United States
Salim Surani, Department of Medicine and Pharmacology, Texas A&M University, Laredo, TX 77843, United States
Author contributions: Paudyal V and Thapa R reviewed the literature, wrote the manuscript, and created the table; Itani A wrote the manuscript and edited it; Sharma M contributed to revising and editing the paper; Rayamajhi R, Ratnani I, and Surani S contributed to revising, editing, and final approval of the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: None of the authors has any conflict of interest to disclose.
Corresponding author: Salim Surani, MD, Professor, Department of Medicine and Pharmacology, Texas A&M University, College Station, 40 Bizzell Street, Laredo, TX 77843, United States. srsurani@hotmail.com
Received: April 14, 2025 Revised: June 4, 2025 Accepted: September 1, 2025 Published online: March 20, 2026 Processing time: 304 Days and 7 Hours
Abstract
Excessive dynamic airway collapse (EDAC) is characterized by weakness in the posterior membranous wall of the airway, which results in more than 50% narrowing of the central airway lumen during expiration. EDAC differs from tracheobronchomalacia, which involves the weakening of the cartilage rather than the membranous wall. EDAC poses a diagnostic challenge due to overlapping symptoms with chronic obstructive pulmonary disease and asthma, including dyspnea, cough, and wheezing. The diagnosis of EDAC relies on dynamic airway imaging techniques, including bronchoscopy, dynamic computed tomography, dynamic magnetic resonance imaging, and endobronchial ultrasound, to assess airway collapse during expiration. Pulmonary function testing helps in ruling out obstructive lung disease. Treatment includes medical management of underlying comorbidities, pulmonary rehabilitation, and, in severe cases, bronchoscopy-guided stenting of the airway or tracheobronchoplasty. This mini-review discusses pathophysiology, diagnostic challenges, and evolving treatment strategies for EDAC, highlighting the need for increased clinical awareness and targeted therapies.
Core Tip: Excessive dynamic airway collapse (EDAC) is a less recognized condition with expiratory airflow limitations that is caused by laxity in the posterior membranous wall, leading to the excessive narrowing of the central airway lumen. The overlap of EDAC symptoms with chronic obstructive pulmonary disease and asthma often delays the accurate diagnosis. This mini-review discusses the role of dynamic imaging modalities in EDAC diagnosis and the different approaches in the management of EDAC, ranging from conservative treatments to surgical options like tracheobronchoplasty. Standardizing diagnostic criteria, tailoring management strategies, and increasing research are crucial in improving patient outcomes in EDAC.
