Tracheomalacia
Key points
- Tracheomalacia is a weakness and floppiness of the walls of the trachea (main airway).
- Tracheomalacia in an infant occurs when the cartilage in the trachea fails to develop properly.
- A doctor's physical examination confirms the symptoms.
- Those with tracheomalacia must be monitored very closely when they have respiratory infections.
Definition
Tracheomalacia is a weakness and floppiness of the walls of the trachea (main airway). There are three types of tracheomalacia. One type is congenital (present at birth), while the others are acquired, meaning that the trachea is normal at birth but becomes floppy later in life in response to something else.
Causes, incidence, and risk factors
Tracheomalacia in an infant occurs when the cartilage in the trachea fails to develop properly. This causes the wall of the trachea to be floppy, rather than relatively rigid as it is supposed to be. The breathing difficulties associated with congenital tracheomalacia (also called Type 1) begin soon after birth.
Other types of tracheomalacia occur because of degeneration of previously normal cartilage making up the wall of the trachea. This can happen from something outside of the trachea causing pressure on the airway (for example, an abnormality of the blood vessels surrounding the trachea or a tumor in the neck or throat) and, therefore, causing changes to the cartilage. This is called type 2 tracheomalacia. Breakdown of the cartilage in the trachea can also happen from prolonged intubation or chronic, recurrent infections involving the trachea - Type 3 tracheomalacia.
All three types of tracheomalacia are very uncommon.
Symptoms
- High-pitched breathing (called stridor) and rattling noisy breaths.
- Breathing problems worsen with coughing, crying, or (in the case of infants) feeding. Upper respiratory infections also worsen symptoms.
- Breathing noises tend to improve during sleep.
Signs and tests
A doctor's physical examination confirms the symptoms. A chest x-ray may show narrowing of the trachea when exhaling. Even if the x-ray shows nothing abnormal, it is needed to rule out other problems.
A definitive diagnosis is obtained by laryngoscopy, which is performed by a otolaryngologist (Ear, Nose, Throat doctor). This allows the doctor to visually examine the airway anatomy and helps determine the extent of tracheomalacia.
Other tests which may be perfomed include airway fluroscopy, barium swallow, bronchoscopy, lung function tests, and Magnetic Resonance Imaging (MRI).
Treatment
Those with tracheomalacia must be monitored very closely when they have respiratory infections. Most infants will respond well to humidified air, physical therapy, careful feedings, and antibiotics for infections.
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.