Tracheal deviation (shifting of the windpipe away from its normal central position) is an important clinical and radiological sign. The causes are classically divided into conditions that pull the trachea toward the affected side and conditions that push it away.
Causes of tracheal deviation
- Trachea shifts away from the affected side — pushing effect
These conditions increase pressure or volume on one side of the chest.
Tension pneumothorax — a medical emergency; air under pressure pushes the mediastinum away.
Massive pleural effusion — large fluid collection pushes the mediastinum away.
Large thoracic tumour or mediastinal mass — may compress and displace the trachea.
Large goitre — an enlarged thyroid can compress or displace the trachea.
Marked unilateral lung hyperinflation — can push the mediastinum toward the opposite side. - Trachea shifts toward the affected side — pulling effect
These conditions cause loss of lung volume or pull on the mediastinum.
Lung collapse (atelectasis) — especially collapse of a major portion of one lung.
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