Chest
ReviewsTracheomalacia and Tracheobronchomalacia in Children and Adults: An In-depth Review
Section snippets
History
The earliest references to the disease we now call TM are from the 1930s and 1940s, when clinicians described congenital thoracic vascular abnormalities that resulted in tracheal obstruction.9, 10, 11In 1948, Gross and Neuhauser12 described an infant with cough, wheezing, cyanosis, and spontaneous hyperextension of the head. Her trachea was compressed by an anomalous innominate artery that, despite surgical correction, had structurally deformed the trachea. One year later, Evans13 described
History
In 1897, Czyhlarz156 was the first to describe the postmortem finding of an unusually large trachea and bronchi. The first clinical report of isolated tracheal enlargement in an adult was by Mounier-Kuhn157 in 1932. Lemoine158 was the first to use bronchoscopy to document acquired tracheal enlargement in the adult in 1949. Additional case reports159, 160, 161of TM in adults began to appear in the 1950s. Ferraris161 described two patients with acquired TM who both reported “expiratory dyspnea,”
Conclusion
TM and TBM are becoming more commonly recognized and treated in children and adults. The causes and, therefore, the treatments vary, so a working knowledge of the options is important. Noninvasive imaging technology is increasingly being employed for diagnosis, and novel treatments, such as definitive surgical placation and stabilization with removable stents, are becoming alternatives to conservative interventions, such as CPAP. As a result of the complexity of these conditions and the options
Acknowledgments
The authors thank Simon Ashiku, MD (Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, MA), Carl O'Donnell, ScD, MPH (Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center), and David Feller-Kopman (Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center) for their help in the preparation of this article.
References (243)
- et al.
Acquired tracheomalacia: etiology and differential diagnosis
Chest
(1975) - et al.
Life-threatening anoxic spells caused by tracheal compression after repair of esophageal atresia: correction by surgery
J Pediatr Surg
(1976) Syndrome of constricting double aortic arch in infancy: report of a case
J Pediatr
(1939)- et al.
Treatment of tracheomalacia: eight years' experience
J Pediatr Surg
(1986) - et al.
Congenital chondromalacia of the trachea
J Thorac Cardiovasc Surg
(1965) - et al.
Tracheobronchomalacia in Hunter's syndrome
Int J Pediatr Otorhinolaryngol
(1993) - et al.
Contemporary surgery of tracheomalacia
J Pediatr Surg
(1986) - et al.
Tracheal compression by the innominate artery in children
Ann Thorac Surg
(1969) - et al.
Primary tracheomalacia
Ann Thorac Surg
(1983) - et al.
Anterior cricoid suspension and tracheal stomal closure for children with cricoid collapse and peristomal tracheomalacia following tracheostomy
J Pediatr Surg
(1993)
Surgical management of secondary tracheomalacia
Ann Thorac Surg
Surgical management of anomalous left pulmonary artery causing tracheobronchial obstruction: pulmonary artery sling
J Thorac Cardiovasc Surg
Airway compression secondary to left atrial enlargment with increased pulmonary artery pressure
Int J Pediatr Otorhinolaryngol
Abnormalities of the bony thorax causing tracheobronchial compression
Int J Pediatr Otorhinolaryngol
Association between pectus excavatum and segmental bronchomalacia
J Pediatr
Aortosternopexy for tracheomalacia following repair of esophageal atresia: evaluation by cine-CT and technical refinement
J Pediatr Surg
Tracheobronchial abnormalities in infants with bronchopulmonary dysplasia
J Pediatr
Surgical implications of bronchopulmonary dysplasia
J Pediatr Surg
Bronchoscopy during the first month of life
J Pediatr Surg
The prevalence of gastroesophageal reflux in children with tracheomalacia and laryngomalacia
Chest
Esophageal atresia: five year experience with 148 cases
J Pediatr Surg
Long-term functional results of prosthetic airway splinting in tracheomalacia and bronchomalacia
J Pediatr Surg
Aortic suspension (aortopexy) for severe tracheomalacia in infants and children
Am J Surg
Advances in the management of major airway collapse: the use of airway stents
Otolaryngol Clin North Am
Tracheal compression as a cause of apnea following repair of tracheoesophageal fistula: treatment by aortopexy
J Pediatr Surg
The flaccid trachea and tracheoesophageal congenital anomalies
J Pediatr Surg
Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment, and anaesthesia management
Paediatr Anaesth
Crocker, D Tracheal dynamics in infants with respiratory distress, stridor, and collapsing trachea
Radiology
A method for the demonstration of calibre changes in the bronchi in normal respiration
J Clin Invest
Acquired tracheobronchomalacia
Eur J Respir Dis
Management of tracheomalacia by aortopexy
Pediatr Surg Int
Pediatric tracheobronchomalacia and major airway collapse
Ann Otol Rhinol Laryngol
Surgical relief for tracheal obstruction from a vascular ring
N Engl J Med
Clinical aspects of persistent right aortic root
N Engl J Med
Compression of the trachea by an anomalous innominate artery: an operation for its relief
Am J Dis Child
Congenital obstructions of the respiratory tract: Part 1. Tracheal malformation
AJR Am J Roentgenol
Vascular rings producing respiratory obstruction in infants
Mayo Clin Proc
Congenital malformations of the trachea, bronchi, and lung
Ann Otol Rhinol Laryngol
Clinical aspects of congenital anomalies of the larynx, trachea, bronchi, and oesophagus: the Semon lecture
J Laryngol Otol
Tracheomalacia
Ann Otol Rhinol Laryngol
Congenital bronchomalacia
Am J Dis Child
Pediatric and adult tracheobronchomalacia
Eur J Cardiothorac Surg
Etiology of stridor in the neonate, infant, and child
Ann Otol Rhinol Laryngol
Tracheobronchomalacia in children
Arch Otolaryngol Head Neck Surg
Series of laryngomalacia, tracheomalacia, and bronchomalacia disorders and their associations with other conditions in children
Pediatr Pulmonol
Innominate artery compression of the trachea: diagnosis and treatment by anterior suspension: a 25-year experience
Ann Otol Rhinol Laryngol
Polychondritis in a newborn presenting as tracheomalacia
Ann Otol Rhinol Laryngol
Airway obstruction and sleep apnea in Hurler and Hunter syndromes
Ann Otol Rhinol Laryngol
Tracheomalacia in infants and children
Ann Otol Rhinol Laryngol
Tracheomalacia
Pediatr Rev
Cited by (546)
Open and Thoracoscopic Aortopexy for Airway Malacia in Children: 15 Year Single Centre Experience
2024, Journal of Pediatric SurgeryInterventionnal bronchoscopy for the treatment of tracheobronchomalacia
2023, Revue des Maladies RespiratoiresA novel ex vivo tracheobronchomalacia model for airway stent testing and in vivo model refinement
2023, Journal of Thoracic and Cardiovascular SurgeryExternal airway splint placement for severe pediatric tracheobronchomalacia
2023, International Journal of Pediatric OtorhinolaryngologyAutomatic segmentation and measurement of tracheal collapsibility in tracheomalacia
2023, Clinical ImagingImprovement in postoperative lung function in patients with moderate to severe airway obstruction after robotic-assisted thoracoscopic tracheobronchoplasty
2023, Journal of Thoracic and Cardiovascular Surgery