Tracheomalacia – What is it?

[Anonymous]

My son has tracheomalacia and I thought it was just from being born with ea/tef, but the more I read it seems to be related to reflux more than the ea/tef. So I will post some info on the respitory part of reflux for you…..

 

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Soft Airways http://www.phoenixchildrenshospital.com/emily/LG/996.html
What it is

Airways carry air from the nose to the lungs. Some children are born with airways that are too soft. Soft airways do not hold their shape, and air does not flow through as well as it should.

There are three places where airways can be soft: the voice box, the windpipe, and the breathing tubes. A person may have softening in one, two or three parts of the airway. This softening is called malacia (pronounced: muh-lay’-she-a).

Signs and symptoms

When the voice box (larynx) is too soft (laryngomalacia), you may hear a high-pitched, crow-like noise when the child breathes in. This noise is called stridor.

When the windpipe (trachea) is too soft (tracheomalacia), you may hear a high-pitched, crow-like noise when the child breathes in (stridor). The child may also wheeze, cough or choke. Severe tracheomalacia can also cause very short spells of no breathing (apnea). Your child may turn blue during these apnea spells.

When the breathing tubes (bronchi) are too soft (bronchomalacia), you may hear wheezing when the child breathes out. Medicines used to treat asthma usually do not help the wheezing from soft airways.
Note: may not help the wheezing, but will help the breathing and opening of the airways

Treatments

When children with soft airways are active, upset, eating or have colds, their breathing may be noisy. When they are calm and lying on their stomachs, their breathing may be quieter.

As children grow, their airways get larger and firmer. In most children, soft airways are gone by two years of age. Some children may have noisy breathing until they are school age.

If children can breathe and are growing, their soft airways are not treated. They will grow out of it. If your child has trouble breathing because of soft airways, your child’s doctor may ask you to see an ear, nose and throat doctor or a pediatric pulmonologist for treatment. The doctor may do a test called a bronchoscopy to look at your child’s airways.
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I thought this was an interesting article, because my son would never sleep on his back until around 20 months of age. Also, when he would “come to” after being put under for dilations (younger than 6 months old) he would gasp for air and the attending nurses thought it was APNEA from the anesthesia, but it was just that he couldn’t breath laying on his back.

 

[Anonymous]

Tracheomalacia

Tracheomalacia is a condition in which the cartilage in the trachea (windpipe) is soft or weakened, causing obstruction or collapse of the trachea’s walls. It is most often a congenital condition that allows the trachea to collapse with inhalation, although it may result if a premature infant requires a breathing tube (intubation) for a long time (acquired tracheomalacia). When the collapse leads to obstruction of the airway, difficulty breathing typical of tracheomalacia results.

Tracheomalacia is most common in infants. Tracheomalacia usually improves by the time the child is 6 to 12 months old and disappears by the time the child is 18 to 24 months old.

Symptoms of tracheomalacia include coarse, noisy breathing (stridor), prolonged exhaling, and a croupy cough. These symptoms become worse during activities such as coughing or crying or if the child develops an upper respiratory infection; this may make feeding difficult. Symptoms can usually be somewhat relieved by placing the infant on his or her stomach.

A medical history and physical examination can indicate the possibility of tracheomalacia, but diagnosis must be confirmed by X-ray or other tests of the trachea.

Usually tracheomalacia improves over time with no medical treatment. However, if obstruction of the airway is consistent and severe, or if the condition is preventing the child from growing normally, surgery may be necessary. Surgical options include tracheostomy, a surgical opening into the trachea to provide an airway; aortopexy, suturing the aortic arch to the sternum to hold the trachea open; or placement of a tracheal stent, a tubular structure placed in the trachea to keep the airway open.

Another excerpt from http://www.drhull.com/EncyMaster/L/laryngomalacia.html
Sometimes the stridor seems to get slightly worse in the first few months of life, but gradually it lessens with the natural stiffening of the airway structures, and normally disappears around about one year of age. Most babies seem more comfortable or less noisy lying in a prone position (on the stomach). If there are significant feeding difficulties, small nipple or dropper feedings might be necessary, or very infrequently, gavage (tube) feedings could be required. Rare severe cases may require nasotracheal intubation or even tracheostomy.

[Anonymous]

Here another interesting fact about Traceomalacia that I found. I think sometimes the arching associated with this may be confused with Sandifer’s sydrome – although that’s just my opinion at this time from having seen how my son reacted to reflux and malacias….

Quote:

In tracheomalacia, the supporting structure of the trachea is too floppy, resulting from weakness of the tracheal walls. In addition, the posterior or membranous portion of the trachea, which does not add support to the trachea, may be wider than normal. Patients exhibit an expiratory stridor, which may resemble wheezing. During heavy breathing, the membranous posterior wall advances anteriorly, where it may approach or even touch the cartilaginous anterior tracheal wall, thus markedly reducing the airway lumen. Symptoms are more prominent in an older infant as the respiratory movement increases. Therefore, posterior tracheal wall migration increases as well. As a result, the affected infant may hyperextend his neck in order to adequately keep his airway open.

http://www.emedicine.com/ent/topic325.htm

*bump*

lansima2006-10-6 21:42:13

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