Tracheomalacia is a rare condition that usually presents at birth. Typically, the walls in your windpipe are rigid. In tracheomalacia, the cartilage of the windpipe does not develop properly in utero, leaving them weak and flaccid. The weakened walls are likely to collapse and cause an obstruction of the airway. This leads to breathing problems.
It’s possible to acquire the condition later in life. This usually occurs when a person has been intubated for a long time or has had recurring inflammation or infection of the trachea.
Tracheomalacia in infants and newborns
Tracheomalacia is often detected in babies between the ages of 4 and 8 weeks. Often the baby has been born with the condition, but it’s not until they start to breathe in enough air to cause wheezing that the condition is noticed.
Sometimes the condition is not harmful and many children outgrow it. Other times, the condition can cause severe and ongoing problems with coughing, wheezing, apnea, and pneumonia.
What are the symptoms?
The most common symptoms of tracheomalacia are:
- wheezing that does not improve with bronchodilator therapy
- unusual sounds when breathing
- breathing difficulty that worsens with activity or when the person has a cold
- high-pitched breathing
- normal vital signs despite apparent breathing problems
- reoccurring pneumonia
- persistent cough
- temporary cessation of breathing, particularly during sleep (apnea)
What are the causes?
Tracheomalacia is extremely rare at any age, but it’s most commonly caused by a malformation of the trachea walls in utero. Why this malformation occurs is not precisely known.
If tracheomalacia is developed later in life, then it might be caused by large blood vessels putting pressure on the airway, a complication of surgery to repair birth defects in the windpipe or esophagus, or from having a breathing tube in place for a long time.
How’s it diagnosed?
A bronchoscopy is often required to diagnose tracheomalacia. This is a direct examination of the airways using a flexible camera. This test allows the doctor to diagnose the type of tracheomalacia, how severe the condition is, and what impact it’s having on your breathing ability.
Children often outgrow tracheomalacia by the time they’re 3 years old. Because of this, invasive treatments are usually not considered until this time has passed, unless the condition is extremely severe.
A child will need to be monitored closely by their medical team and might benefit from a humidifier, chest physical therapy, and possibly a continuous positive airway pressure (CPAP) device.
If the child does not outgrow the condition, or if they have a severe case of tracheomalacia, then there are many surgical options available. The kind of surgery offered will depend upon the type and location of their tracheomalacia.
The treatment options for adults with tracheomalacia are the same as those for children, but treatment is less successful in adults.
Tracheomalacia is an extremely rare condition in any age group. In children, it’s usually a manageable condition in which the symptoms lessen over time and are often completely eliminated by the time the child is 3. There are a number of measures that can be taken to help ease symptoms until the time that they disappear naturally.
In rare cases, where symptoms do not improve or are severe, then surgery may be required. Surgery in these instances has a high success rate.
In adults, the condition is often difficult to manage, more likely to be severe, and has a high mortality rate.