Tracheomalacia

Tracheomalacia is a condition where the trachea (windpipe) is abnormally soft or weak, causing it to collapse during breathing, especially when exhaling. This can lead to airway obstruction, noisy breathing, and recurrent respiratory issues.

📂 Types of Tracheomalacia

Congenital (Primary):
- Present at birth
- Caused by abnormal cartilage development in the trachea
- Often associated with conditions like esophageal atresia, tracheoesophageal fistula, or genetic syndromes
Acquired (Secondary):
- Develops later in life due to:
  - Prolonged intubation or tracheostomy
  - Chronic infections
  - External compression from tumors or blood vessels
  - Inflammation (e.g., relapsing polychondritis)

🩺 Symptoms:

Noisy breathing (stridor or wheezing), especially when exhaling
Barking cough
Frequent respiratory infections
Breathing difficulty during feeding or crying (in infants)
Cyanosis (bluish lips/skin in severe cases)
Recurrent bronchitis or pneumonia
Apnea or brief breathing pauses (in severe cases)

🔍 Diagnosis:

Flexible bronchoscopy – Gold standard: directly visualizes airway collapse
CT scan or MRI – To assess the airway structure and rule out compression
Fluoroscopy – Dynamic imaging while breathing
Pulmonary function tests – In older children or adults

📏 Severity:

Mild: May cause noisy breathing but little functional impairment
Moderate to Severe: Can cause significant respiratory distress, infections, or failure to thrive

💊 Treatment:

🔹 Mild Cases:

Often improve with time and growth
Airway clearance therapy
Humidified air and chest physiotherapy
Monitoring and supportive care

🔹 Moderate to Severe Cases:

CPAP or BiPAP: To splint airway open during sleep
Treat underlying causes (e.g., reflux, infection)
Surgery may be required:
- Aortopexy – Lifts blood vessel off the trachea
- Tracheopexy – Suturing the trachea to prevent collapse
- Tracheostomy – For bypassing the weak section in very severe cases
- Stent placement (rare due to complications)