Series of laryngomalacia, tracheomalacia, and bronchomalacia disorders and their associations with other conditions in children

Abstract

Laryngomalacia, bronchomalacia, and tracheomalacia are commonly seen in pediatric respiratory medicine, yet their patterns and associations with other conditions are not well-understood. We prospectively video-recorded bronchoscopic data and clinical information from referred patients over a 10-year period and defined aspects of interrelationships and associations. Two hundred and ninety-nine cases of malacia disorders (34%) were observed in 885 bronchoscopic procedures. Cough, wheeze, stridor, and radiological changes were the most common symptoms and signs. The lesions were most often found in males (2:1) and on the left side (1.6:1). Concomitant malacia lesions ranged from 24% for laryngotracheobronchomalacia to 47% for tracheobronchomalacia. The lesions were found in association with other disorders such as congenital heart disorders (13.7%), tracheo-esophageal fistula (9.6%), and various syndromes (8%). Even though the understanding of these disorders is in its infancy, pediatricians should maintain a level of awareness for malacia lesions and consider the possibility of multiple lesions being present, even when one symptom predominates or occurs alone.

Lower airway anomalies in infants with laryngomalacia

“…14,15 Ian et al had noted that the risk of respiratory illnesses in the malacia group was twice that of the control group. 13 In total, chronic cough was present in 30% of children with airway malacia in the present study. A similar observation was also made by Marchant who showed that a significant number of children with chronic cough have malacia disorders.…”

“…12 Bronchomalacia was observed to be more common on the left side (5 against 1 case) while those with tracheobronchomalacia had bronchomalacia more frequently on the right side (5 against 1 case). Ian Masters et al had also observed that airway malacias were common on the left side 13 while Yalcin and colleagues 10 had noted that malacia disorders were more commonly on the right.…”

Silicone stents, the rigid bronchoscope, and the standard of care in central airway stenosis

“…The congenital form of TBM is well described in the pediatric literature [68][69][70], and may be associated with other congenital conditions. The adult forms of TBM are idiopathic or acquired during the course of other illnesses, and are disorders of middle-aged and older persons.…”

Airway obstruction during general anesthesia in a premature infant suspecting bronchospasm and/or airway malacia -A case report-

“…It is generally a benign condition and usually self-limited, because dynamic airway collapse improves as the airway structures mature. The airway that is maintained during spontaneous breathing could be altered by positive airway pressure changes in patients with airway malacia [3]. When the trachea is compressed or functional narrowing occurs, intermittent respiratory obstruction and arterial desaturation may occur [4][5][6].…”