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Definition

Tracheomalacia is abnormally weak or soft cartilage (tissue) in the trachea (windpipe). It may cause the cartilage to collapse. This can make it hard for air to move smoothly to the lungs.

This problem is most often present at birth or soon after.

Air Pathway

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Causes

It is not known exactly why this problem happens in babies.

Tracheomalacia that develops later in life may be caused by injury or trauma to the throat, such as:

  • Prolonged intubation
  • Tracheotomy
  • Tracheobronchitis
  • Compression of the trachea due to tumors and cysts, or heart, blood vessel, or skeletal abnormalities
  • Repeat infections

Risk Factors

This condition is more common in babies who are born very early. It is also more common in babies who are born with esophageal atresia. This occurs when a baby is born without part of the esophagus. This is the tube that connects the mouth to the stomach.

Tracheomalacia that develops later in life is more likely with:

  • Prolonged intubation
  • Recent tracheotomy
  • Tracheobronchitis

Symptoms

Symptoms will depend on the severity of the tracheomalacia but may include:

  • Problems breathing
  • High-pitched or rattling breathing
  • Cough

Diagnosis

The doctor will ask about your (or your baby’s) symptoms and health history. A physical exam will be done.

Images may need to be taken to view the trachea. This can be done with:

Treatment

This problem usually goes away on its own as a baby develops. It often is gone by the time a child is 2 years old.

People with severe symptoms may need treatment to ease or to correct the problem. Choices are:

  • Supportive care, such as warm air therapy
  • Devices, such as a continuous positive airway pressure (CPAP) machine to keep the airway open

Rarely, people with severe symptoms may need surgery. Choices are:

  • Moving nearby soft tissue to ease pressure on the trachea
  • Removing the part of the trachea that is causing the problem
  • Placing a device in the trachea to help hold the trachea open

Prevention

There are no current guidelines to prevent this health problem.

RESOURCES:

Boston Children’s Hospital
http://www.childrenshospital.org

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca

Health Canada
https://www.canada.ca

REFERENCES:

Santer D, D’Alessandro M. Tracheo/laryngomalacia. Virtual Pediatric Hospital website. Available at: http://www.virtualpediatrichospital.org/providers/ElectricAirway/Text/TracheoLaryngo.shtml. Accessed October 28, 2020.

Tracheomalacia. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/tracheomalacia. Accessed October 28, 2020.

Tracheomalacia. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/tracheomalacia. Accessed October 28, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 5/5/2021