Abstract
Congenital tracheomalacia is the most common congenital tracheal abnormality and occurs
in approximately 1:2,100 children. Tracheomalacia can be isolated or associated with
other airway anomalies such as laryngomalacia, bronchomalacia, and large laryngeal
clefts. Also, an abnormal division of the embryonic foregut is frequently associated
with congenital tracheomalacia; mostly in the form of proximal esophageal atresia
with distal tracheoesophageal fistula. In such cases, the ratio between the cartilage
ring and the posterior membranous wall drops from the normal ratio of 4 to 5:1 to
2 to 3:1. The diagnosis can be made upon clinical history and physical examination
as well as by pulmonary function testing, computed tomography, dynamic magnetic resonance
imaging, and fiberoptic bronchoscopy. Other approaches such as tracheobronchography
have been used, but have not been validated for the diagnosis of tracheomalacia; fluoroscopy
can be specific for diagnosing tracheomalacia, but lacks a reasonable sensitivity.
Tracheomalacia is often self-limited and will resolve or become asymptomatic by the
second year of life without intervention. For patients who remain symptomatic, possible
treatments include pharmacotherapy, positive pressure application, and surgery.
Keywords
tracheomalacia - children - diagnosis
