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Tracheomalacia - acquired
Secondary tracheomalacia
Acquired tracheomalacia is a weakness and floppiness of the walls of the windpipe (trachea, or airway). It develops after birth.
See also: Congenital tracheomalacia
Congenital tracheomalacia
Congenital tracheomalacia is a weakness and floppiness of the walls of the windpipe (trachea). Congenital means it is present at birth.
Causes
Acquired tracheomalacia is very uncommon at any age. It occurs when normal cartilage in the wall of the windpipe begins to break down.
This form of tracheomalacia may result:
- When large blood vessels put pressure on the airway
- As a complication after surgery to repair birth defects in the windpipe and esophagus (the tube that carries food from the mouth to the stomach)
- After having a breathing tube or trachea tube (tracheostomy) for a long time
Symptoms
Symptoms of tracheomalacia include:
- Breathing problems that get worse with coughing, crying, or upper respiratory infections, such as a cold
- Breathing noises that may change when body position changes, and improve during sleep
- High-pitched breathing
- Rattling, noisy breaths
Exams and Tests
A physical examination confirms the symptoms. A chest x-ray may show narrowing of the trachea when breathing out. Even if the x-ray is normal, it is needed to rule out other problems.
A procedure called a laryngoscopy is used to diagnose the condition. This procedure allows the otolaryngologist (ear, nose, and throat doctor, or ENT) to see the structure of the airway and determine how severe the problem is.
Laryngoscopy
Laryngoscopy is an exam of the voice box (larynx). It can be done using a small mirror held just below the back of your palate, or a rigid or flexib...
Other tests may include:
- Airway fluoroscopy
- Barium swallow
-
Bronchoscopy
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
Read Article Now Book Mark Article - CT scan
- Lung function tests
- Magnetic resonance imaging (MRI)
Treatment
The condition may improve without treatment, but people with tracheomalacia must be monitored closely when they have respiratory infections.
Adults with breathing problems may need continuous positive airway pressure (CPAP). Rarely, surgery is needed. A hollow tube called a stent may be placed to hold the airway open.
Continuous positive airway pressure
CPAP stands for continuous positive airway pressure. CPAP pumps air under pressure into the airway of the lungs, keeping the windpipe open during sl...
Stent
A stent is a tiny tube placed into a hollow structure in your body. This structure can be an artery, a blood vessel, or something such as the tube t...
Possible Complications
Aspiration pneumonia (a lung infection) can occur from breathing in food.
Aspiration pneumonia
Pneumonia is a breathing condition in which there is swelling or an infection of the lungs or large airways. Aspiration pneumonia occurs when food, ...
Adults who develop tracheomalacia after being on a breathing machine often have serious lung problems.
When to Contact a Medical Professional
Call your health care provider if you or your child breathes in an abnormal way. Tracheomalacia can become an urgent or emergency condition.
References
Gaissert HA, Burns J. The compromised airway: tumors, strictures, and tracheomalacia. Surg Clin North Am . 2010;90(5):1065-89.
Kugler C, Stanzel F. Tracheomalacia. Thoracic Surg Clin . 2014;24(1):51-8.
Nelson M, Green G, Ohye RG. Pediatric tracheal anomalies. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 206.
Review Date: 4/21/2015
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
