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Tracheomalacia

Tray-key-o-ma-lay-sha

Definition

The trachea (windpipe) is a tube of soft tissue that is supported by rings of stronger tissue called cartilage. This tube creates a pathway for air to pass from the mouth to the lungs.

Tracheomalacia is weak or soft cartilage in the trachea. It may cause the cartilage to collapse. The collapsed tissue can make it difficult for air to move smoothly to the lungs. TracheomalaciaIt is most often present at birth or soon after.

Air Pathway

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Causes    TOP

It is not known exactly why this condition develops 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    TOP

This condition is more common in babies who are born prematurely and those who are born with esophageal atresia. Esophageal atresia occurs when a baby is born without part of the esophagus, which connects the mouth to the stomach.

Tracheomalacia that develops later in life are more likely with:

  • Prolonged intubation
  • Recent tracheotomy
  • Tracheobronchitis

Symptoms    TOP

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

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

Diagnosis    TOP

You will be asked about your or your baby’s symptoms and medical history. A physical exam will be done.

The trachea may need to be viewed and images may need to be taken. This may be done with:

Treatment    TOP

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

Treatment may be needed to relieve symptoms or to correct the problem in severe cases. Talk with your doctor about the best treatment plan. Options include:

Warm Air Therapy

A humidifier may be used to increase the humidity in your baby’s environment. It may make it easier for your baby to breathe.

Continuous Positive Airway Pressure (CPAP)

A continuous positive airway pressure (CPAP) device may be used to keep the tissues and throat open to help your baby breathe as they continue to develop.

Surgery    TOP

Surgery is rare, but may be needed if there are problems with eating or breathing. Surgical options include:

  • Moving nearby soft tissue to relieve pressure on the trachea
  • Removing the segment of the trachea that is causing the condition
  • Placing a device in the trachea to help hold the trachea open

Surgery may be more likely in those who develop tracheomalacia later in life.

Prevention    TOP

There are no current guidelines to prevent tracheomalacia because the cause is unknown.

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

References:

Kugler C, Stanzel F. Tracheomalacia. Thorac Surg Clin. 2014;24(1):51–58.
Santer D, D’Alessandro M. Tracheo/laryngomalacia. Virtual Pediatric Hospital website. Available at:
...(Click grey area to select URL)
Accessed July 29, 2014.
Tracheomalacia. Boston Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed July 9, 2014.
Tracheomalacia. Johns Hopkins Medicine website. Available at:
...(Click grey area to select URL)
Accessed July 9, 2014.
Last reviewed June 2016 by James Cornell, MD
Last Updated: 9/5/2014

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