Tracheomalacia/Laryngomalacia
Basics
DESCRIPTION
- Malacia refers to “softness” of airway structures.
- Laryngomalacia
- Dynamic collapse of the supraglottic structures of the larynx resulting in airway obstruction
- Most common congenital anomaly of the larynx
- Most common noninfectious cause of stridor in children
- Tracheomalacia
- Dynamic collapse of the trachea resulting in airway obstruction during forceful respiratory maneuvers
- Common cause of chronic wheezing in infants and children
- Clinical manifestations depend on if lesion is part of the intrathoracic or extrathoracic portions of the trachea.
- Intrathoracic tracheomalacia: Airway collapse occurs during exhalation because pleural pressure exceeds luminal pressure.
- Extrathoracic tracheomalacia: Airway collapse occurs during inhalation because atmospheric pressure exceeds luminal pressure.
ETIOLOGY
- Laryngomalacia
- Anatomic abnormalities:
- Short aryepiglottic folds
- Elongated, flaccid, omega-shaped epiglottis prolapses posteriorly.
- Redundant arytenoid mucosa
- Neurologic abnormalities:
- Immaturity of neuromuscular control results in hypotonia of pharyngeal muscles.
- Anatomic abnormalities:
- Tracheomalacia
- Weakness of the tracheal wall secondary to softening of the anterior cartilaginous rings and/or decreased tone of the posterior membranous wall
- Classified as primary or secondary
- Primary: congenital; most common congenital tracheal abnormality occurring in 1:2,100 children; results from immature development of the tracheal structures; may occur with other congenital anomalies such as tracheoesophageal fistula, laryngomalacia, and facial anomalies
- Secondary: acquired in a normally developed trachea after some insult such as prolonged positive pressure ventilation, recurrent infection or aspiration, or external compression
- With increasing age, the length, area, thickness, and amount of cartilage increases in the anterior rings as well as the size and contractility of the membranous wall.
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Cabana, Michael D., editor. "Tracheomalacia/Laryngomalacia." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia.
Tracheomalacia/Laryngomalacia. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia. Accessed December 18, 2024.
Tracheomalacia/Laryngomalacia. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia
Tracheomalacia/Laryngomalacia [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2024 December 18]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Tracheomalacia/Laryngomalacia
ID - 14129
ED - Cabana,Michael D,
BT - Select 5-Minute Pediatrics Topics
UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia
PB - Wolters Kluwer Health
ET - 7
DB - Medicine Central
DP - Unbound Medicine
ER -