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
- 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.
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; 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
- During exhalation, increased collapsing pressure across a compliant airway wall causes invagination of the posterior membrane.
- 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.
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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 May 31, 2023.
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 2023 May 31]. 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
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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
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DB - Medicine Central
DP - Unbound Medicine
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