Tracheomalacia
| Tracheomalacia | |
|---|---|
| Classification and external resources | |
| ICD-10 | Q32.0 |
| ICD-9 | 519.19, 748.3 |
| DiseasesDB | 31858 |
| eMedicine | med/2976 ped/2275 |
Tracheomalacia (from trachea and the Greek μαλακία, softening) is a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse especially when increased airflow is demanded.
The trachea normally dilates slightly during inspiration and narrows slightly during expiration. These processes are exaggerated in tracheomalacia, leading to airway collapse on expiration. The usual symptom of tracheomalacia is expiratory stridor or laryngeal crow.
If the condition extends further to the bronchi (if there is also bronchomalacia), it is termed tracheobronchomalacia. The same condition can also affect the larynx, which is called laryngomalacia.
Classification
There are three types:[1]
- Type 1 — congenital, sometimes associated with tracheoesophageal fistula or esophageal atresia
- Type 2 — extrinsic compression sometimes due to vascular rings
- Type 3 — acquired due to chronic infection or prolonged intubation or inflammatory conditions like relapsing polychondritis
Treatment
If the symptoms are severe enough, treatment may be needed. These range from medical management over mechanical ventilation (both continuous positive airway pressure, CPAP, or bi-level positive airway pressure, BiPAP) to tracheal stenting and surgery.
Surgical techniques include aortopexy, tracheopexy, tracheobronchoplasty, and tracheostomy.[2] None of these techniques has been shown to be more effective than the other.[3]
See also
- Tracheal collapse for the condition in dogs
Footnotes
- ↑ Austin J, Ali T (January 2003). "Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management". Paediatr Anaesth 13 (1): 3–11. doi:10.1046/j.1460-9592.2003.00802.x. PMID 12535032.
- ↑ van der Zee DC, Bax NM (2007). "Thoracoscopic tracheoaortopexia for the treatment of life-threatening events in tracheomalacia". Surgical endoscopy 21 (11): 2024–2025. doi:10.1007/s00464-007-9250-8. PMID 17356936.
- ↑ Masters IB, Chang AB (2005). "Interventions for primary (intrinsic) tracheomalacia in children". In Masters, I Brent. Cochrane Database Syst Rev (4): CD005304. doi:10.1002/14651858.CD005304.pub2. PMID 16235399.
External links
- Swiss embryology (from UL, UB, and UF) rrespiratory/patholrespi01
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