PURPOSE: Patients with expiratory central airway collapse present with various symptoms, etiologies, morphologic types, extent and severity of airway collapse. This study delineates a common multidimensional classification system and language that can be used by health care providers to objectively evaluate these patients before and after therapy.
METHODS: The FEMOS classification addresses the Morphology and Origin of the abnormality as well as stratification parameters such as Functional status, Extent, and Severity of airway collapse as identified on bronchoscopy (Table). From our bronchoscopy database we identified patients diagnosed with expiratory central airway collapse between June 2003 and December 2005. FEMOS was used before and after treatment to assess the usefulness of stratification parameters (Figure). Descriptive statistical analysis was used to illustrate frequency distributions.
RESULTS: Eighteen patients who underwent both clinical and bronchoscopic follow up constituted the subjects of this study. All patients were symptomatic at presentation. Two patients were treated conservatively, 15 had rigid bronchoscopy with silicone stent insertion and one had tracheostomy. Functional status improved by one class in 12 patients, by two classes in 4 patients and remained unchanged in 2 patients. Severity of airway collapse improved in 15 and remained unchanged in 3 patients. Extent of abnormality diminished in 14 patients and did not change in 4 patients. FEMOS characterized morphologic and etiologic types of airway collapse: 4 patients had excessive dynamic airway collapse (idiopathic, 1; secondary, 3) and 14 had tracheobronchomalacia (secondary, 14).
CONCLUSION: FEMOS identifies the morphologies and etiologies of expiratory central airway collapse and allows objective stratification of patients according to the degree of functional impairment, extent and severity of airway collapse.
CLINICAL IMPLICATIONS: FEMOS is a multidimensional classification system that provides a meaningful common language to characterize patients with expiratory central airway collapse in order to compare results of individualized treatment strategies.
DISCLOSURE: Septimiu Murgu, None.