Alfin G. Vicencio, MD Attending in Pediatric Pulmonary - Steven and Alexandra Cohen Childrens Med Center
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Tracheomalacia and Bronchomalacia in Children Male: Sometimes kids have soft windpipes, laryngomalacia and sometimes tracheomalacia. Are they pretty common? Alfin G. Vivencio: Probably a little bit more common than we think. There are many children who have current episodes of wheezing, that you get a very, very loud, harsh wheeze that sometimes you can hear a vasodilator. And some of those children will actually have some defects in their large airway where the cartilage isn’t as rigid as it is in most children and when you get viral infections then sometimes you can actually increase the pressure on the lungs and cause collapse of the lungs. Male: They sound sick sometimes when they have a little problem area. Alfin G. Vivencio: Yes, sometimes in the area. Those some of the children also have that very -- Male: Did they ever end up with any kind of -- down the road? Alfin G. Vivencio: Very rare but there are certain children who for example if they’re not growing well or if they’re having a lot of life threatening episodes of apnea that require surgical intervention and one type of surgery that can best is called tracheoplasty which the surgeon will actually lift the large artery that sits on top of the airway and sew it in position so that it does not cause a lot of pressure in the airway. Male: Sometimes you look down and you think you cannot find little webs or something to? Alfin G. Vivencio: Again rarely but sometimes we do find certain types of airway lesions that can cause a lot of wheezing and respiratory problems. Just last week, we saw somebody who had poorly controlled asthma for the past two days. Male: So sometimes you have a tumor, a mass. So the criteria would be you're not getting good control so you get to look beyond what we normally would say it’s just a kid. It just wheezes. Sometimes you have to look down and see there’s an anatomical reason. Alfin G. Vivencio: Yes, absolutely. Those are more rare cases but absolutely and -- Male: So a good rule is, if you can’t get the kid controlled with conventional names. That’s a little bit of a red flag that we need someone in the area of pulmonary to look at the kid to confirm you did what you should and something else behind it. Alfin G. Vivencio: Yeah, that’s the first thing. Male: So how that’s we able to build nice relationship and a good partnership down the road. Alfin G. Vivencio: Yes, absolutely. Male: That’s called good practice. Alfin G. Vivencio: Yeah.