The trachea is also known as the windpipe. Tracheal deviation, or tracheal displacement, is when the trachea shifts from its usual position in the neck and chest to one side. It is a symptom rather than a distinct diagnosis.

Tracheal deviation most commonly occurs due to increased pressure in the chest. This can result from tension pneumothorax, commonly known as a collapsed lung.

Blood in the chest, cancer, other growths in the neck or chest, and pleural effusion, which is fluid in the chest, may also cause tracheal deviation.

Read on to learn more about tracheal deviation, including the causes, symptoms, and treatment.

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Tracheal deviation is when the trachea, or windpipe, shifts to one side of the neck or chest.

The trachea is the pipe that carries air from the nose and mouth to the lungs. Usually, it runs straight down the middle of the neck and chest. When it deviates, this can cause changes in breathing.

Tracheal deviation can signal a serious underlying medical condition that has caused an increase in chest pressure. A doctor may examine someone for tracheal deviation if they suspect they have a collapsed lung, as it is a strong indicator of the condition.

However, according to an older 2009 paper, tracheal deviation may be a typical variation in infants and young children. In this age group, the trachea may deviate slightly to the right.

As this symptom can be a sign of something serious, people should treat it as a medical emergency.

Any condition that increases chest pressure may cause tracheal deviation. This includes:

  • Pneumothorax: This is a collapsed lung, which can increase pressure in the chest and move the trachea.
  • Scoliosis: Severe scoliosis, or curvature of the spine, can sometimes put pressure on the trachea, causing it to move. This may affect breathing.
  • Growths in the chest: Growths in the chest, such as cancer, may move the trachea.
  • Atelectasis: This is where the air sacs within the lungs do not correctly expand.
  • Hemothorax: This means there is blood in the chest, which may move the trachea.
  • Chest injuries: Certain injuries could potentially move the trachea. For example, a 2020 case report describes tracheal deviation in a person who underwent gallbladder surgery. A tube placed in a central vein in the neck caused a hematoma, or large bruise, in the chest, leading to tracheal deviation.

The symptoms of tracheal deviation may include:

These symptoms could begin suddenly or gradually, depending on the underlying cause. For example, scoliosis may cause symptoms to develop gradually, whereas pneumothorax is sudden. The underlying condition may also cause additional symptoms.

Doctors usually diagnose a tracheal deviation with imaging scans, such as an X-ray.

If a collapsed lung is the cause of the tracheal deviation, the displacement will usually occur on the opposite side of the collapsed lung. So if the right lung collapses, the trachea may deviate to the left.

To diagnose the underlying cause, a doctor may:

  • take a complete medical history
  • perform a physical exam of the chest and neck
  • request an angiogram to look for signs of bleeding
  • order additional imaging scans

If a person is having difficulty breathing, doctors may begin treatment before they receive the results of any diagnostic tests. For example, they may give oxygen therapy to ensure a person is getting enough.

Treatment for tracheal deviation aims to address the underlying cause. By doing this, the trachea may return to its original place.

When a collapsed lung is the cause, a person will need supplemental oxygen as well as ongoing monitoring. They may need treatment for injuries to the chest. In some cases, a doctor may insert a needle into the chest to relieve accumulated pressure.

In around 90% of cases, a tube in the chest is enough to support breathing, but some people may need surgery. This may mean thoracoscopic surgery or a thoracotomy, which involves making a cut between the ribs to access the lungs.

For other causes of tracheal deviation, the treatment may be different. For example, a person with severe scoliosis may need surgery to reduce the curvature of the spine, while a person with cancer may need chemotherapy or radiation treatment.

Each case is different. A doctor can outline the treatment plan according to an individual’s circumstances.

The outlook for tracheal deviation depends on many factors, including the cause, its severity, and the available treatments. However, many of its causes are serious.

A collapsed lung, blood in the chest, and damage to the sacs of the lungs can be fatal without prompt treatment. A collapsed lung can also recur in the future, particularly if a person has risk factors for this, such as:

However, scoliosis usually progresses very slowly in adults, if at all. Similarly, cancer in the chest can be slow- or fast-growing. As a result, a person’s outlook depends on what exactly is causing the trachea to move.

Tracheal deviation is a symptom of several serious — and potentially life threatening — medical conditions. For this reason, it always requires prompt medical care.

Diagnosing and treating the underlying issue is key to treating tracheal deviation. With the right care, a person can recover. They may need to consult a specialist to develop a long-term recovery plan and to reduce the risk of another tracheal deviation.