Tracheomalacia

Tracheomalacia is an abnormal collapse of the walls of the windpipe (trachea). It may be due an abnormal development of the windpipe, resulting in walls that are soft and collapse during respiration. Alternatively this may occur in combination with other lesions that cause compression or damage to the airway.

The child presents with a stridor (noisy breathing) or a wheeze, usually around 4 to 8 weeks of age. The wheeze generally increases with activity and colds. The wheezing may be mistaken for bronchiolitis or asthma.
The paediatric ENT surgeon would need to carry out a bronchoscopy to make the definitive diagnosis and rule out other causes. A CT scan, fluoroscopy or barium swallow x-rays may also be helpful.

In most children, the cartilages of the trachea stiffen, the airway enlarges and symptoms resolve by 3 years of age. Often supportive treatment is all that is required while the child is growing if the symptoms are mild or intermittent. The more severely affected children may require some form of help with ventilatory support, tracheostomy or other forms of surgical intervention depending on the cause.

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