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Tracheobronchomalacia
Randy R. Richardson, MD; Mantosh S. Rattan, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Excessive dynamic airway collapse
              • Definitions

                • Excessive expiratory collapse of trachea or bronchi
                  • May be purely intrinsic or in association with longstanding extrinsic compression

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Poore TS et al: Vascular and pulmonary comorbidities in children with congenital EA/TEF. Pediatr Pulmonol. 56(2):571-7, 2021
                                          2. Gunatilaka CC et al: Increased work of breathing due to tracheomalacia in neonates. Ann Am Thorac Soc. 17(10):1247-56, 2020
                                          3. Hysinger EB et al: Ultrashort echo-time MRI for the assessment of tracheomalacia in neonates. Chest. 157(3):595-602, 2020
                                          4. Léonard M et al: Co-dominant double aortic arch: a rare cause of vascular ring causing tracheomalacia in a child. Acta Cardiol. 1-2, 2020
                                          5. Williams SP et al: Aortopexy for the management of paediatric tracheomalacia - the Alder Hey experience. J Laryngol Otol. 1-4, 2020
                                          6. Cohen SL et al: Ultralow dose dynamic expiratory computed tomography for evaluation of tracheomalacia. J Comput Assist Tomogr. 43(2):307-11, 2019
                                          7. Wallis C et al: ERS statement on tracheomalacia and bronchomalacia in children. Eur Respir J. 54(3), 2019
                                          8. McInnis MC et al: Advanced technologies for imaging and visualization of the tracheobronchial tree: from computed tomography and MRI to virtual endoscopy. Thorac Surg Clin. 28(2):127-37, 2018
                                          9. Mohakud S et al: Tracheomalacia with tracheal bronchus. Natl Med J India. 31(1):57, 2018
                                          10. Shepard JO et al: Imaging of the trachea. Ann Cardiothorac Surg. 7(2):197-209, 2018
                                          11. Ciet P et al: Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging. Pediatr Radiol. 45(13):1901-15, 2015
                                          12. Ciet P et al: Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients. Eur Respir J. 43(1):115-24, 2014
                                          13. Mitchell ME et al: Anterior tracheal suspension for tracheobronchomalacia in infants and children. Ann Thorac Surg. 98(4):1246-53, 2014
                                          14. Vondrys D et al: First experience with biodegradable airway stents in children. Ann Thorac Surg. 92(5):1870-4, 2011
                                          15. Lee EY et al: Expiratory volumetric MDCT evaluation of air trapping in pediatric patients with and without tracheomalacia. AJR Am J Roentgenol. 194(5):1210-5, 2010
                                          16. Lee EY et al: MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience. Pediatr Radiol. 38(1):82-8, 2008
                                          17. Lee EY et al: MDCT evaluation of the prevalence of tracheomalacia in children with mediastinal aortic vascular anomalies. J Thorac Imaging. 23(4):258-65, 2008
                                          18. Carden KA et al: Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 127(3):984-1005, 2005
                                          19. Fraser RS et al: Upper airway obstruction. In: Fraser RS et al: Synopsis of Diseases of the Chest. 3rd ed. Saunders. 631-4, 2005
                                          20. Boiselle PM et al: Tracheobronchomalacia: evolving role of dynamic multislice helical CT. Radiol Clin North Am. 41(3):627-36, 2003
                                          21. Wright CD: Tracheomalacia. Chest Surg Clin N Am. 13(2):349-57, viii, 2003
                                          22. Walner DL et al: Utility of radiographs in the evaluation of pediatric upper airway obstruction. Ann Otol Rhinol Laryngol. 108(4):378-83, 1999
                                          23. Davis S et al: Effect of continuous positive airway pressure on forced expiratory flows in infants with tracheomalacia. Am J Respir Crit Care Med. 158(1):148-52, 1998
                                          24. Paston F et al: Tracheomalacia. Pediatr Rev. 17(9):328, 1996
                                          25. Jacobs IN et al: Tracheobronchomalacia in children. Arch Otolaryngol Head Neck Surg. 120(2):154-8, 1994
                                          26. Mair EA et al: Pediatric tracheobronchomalacia and major airway collapse. Ann Otol Rhinol Laryngol. 101(4):300-9, 1992
                                          27. Miller RW et al: Effectiveness of continuous positive airway pressure in the treatment of bronchomalacia in infants: a bronchoscopic documentation. Crit Care Med. 14(2):125-7, 1986
                                          28. Holinger LD: Etiology of stridor in the neonate, infant and child. Ann Otol Rhinol Laryngol. 89(5 Pt 1):397-400, 1980
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Excessive dynamic airway collapse
                                                      • Definitions

                                                        • Excessive expiratory collapse of trachea or bronchi
                                                          • May be purely intrinsic or in association with longstanding extrinsic compression

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Poore TS et al: Vascular and pulmonary comorbidities in children with congenital EA/TEF. Pediatr Pulmonol. 56(2):571-7, 2021
                                                                                  2. Gunatilaka CC et al: Increased work of breathing due to tracheomalacia in neonates. Ann Am Thorac Soc. 17(10):1247-56, 2020
                                                                                  3. Hysinger EB et al: Ultrashort echo-time MRI for the assessment of tracheomalacia in neonates. Chest. 157(3):595-602, 2020
                                                                                  4. Léonard M et al: Co-dominant double aortic arch: a rare cause of vascular ring causing tracheomalacia in a child. Acta Cardiol. 1-2, 2020
                                                                                  5. Williams SP et al: Aortopexy for the management of paediatric tracheomalacia - the Alder Hey experience. J Laryngol Otol. 1-4, 2020
                                                                                  6. Cohen SL et al: Ultralow dose dynamic expiratory computed tomography for evaluation of tracheomalacia. J Comput Assist Tomogr. 43(2):307-11, 2019
                                                                                  7. Wallis C et al: ERS statement on tracheomalacia and bronchomalacia in children. Eur Respir J. 54(3), 2019
                                                                                  8. McInnis MC et al: Advanced technologies for imaging and visualization of the tracheobronchial tree: from computed tomography and MRI to virtual endoscopy. Thorac Surg Clin. 28(2):127-37, 2018
                                                                                  9. Mohakud S et al: Tracheomalacia with tracheal bronchus. Natl Med J India. 31(1):57, 2018
                                                                                  10. Shepard JO et al: Imaging of the trachea. Ann Cardiothorac Surg. 7(2):197-209, 2018
                                                                                  11. Ciet P et al: Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging. Pediatr Radiol. 45(13):1901-15, 2015
                                                                                  12. Ciet P et al: Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients. Eur Respir J. 43(1):115-24, 2014
                                                                                  13. Mitchell ME et al: Anterior tracheal suspension for tracheobronchomalacia in infants and children. Ann Thorac Surg. 98(4):1246-53, 2014
                                                                                  14. Vondrys D et al: First experience with biodegradable airway stents in children. Ann Thorac Surg. 92(5):1870-4, 2011
                                                                                  15. Lee EY et al: Expiratory volumetric MDCT evaluation of air trapping in pediatric patients with and without tracheomalacia. AJR Am J Roentgenol. 194(5):1210-5, 2010
                                                                                  16. Lee EY et al: MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience. Pediatr Radiol. 38(1):82-8, 2008
                                                                                  17. Lee EY et al: MDCT evaluation of the prevalence of tracheomalacia in children with mediastinal aortic vascular anomalies. J Thorac Imaging. 23(4):258-65, 2008
                                                                                  18. Carden KA et al: Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 127(3):984-1005, 2005
                                                                                  19. Fraser RS et al: Upper airway obstruction. In: Fraser RS et al: Synopsis of Diseases of the Chest. 3rd ed. Saunders. 631-4, 2005
                                                                                  20. Boiselle PM et al: Tracheobronchomalacia: evolving role of dynamic multislice helical CT. Radiol Clin North Am. 41(3):627-36, 2003
                                                                                  21. Wright CD: Tracheomalacia. Chest Surg Clin N Am. 13(2):349-57, viii, 2003
                                                                                  22. Walner DL et al: Utility of radiographs in the evaluation of pediatric upper airway obstruction. Ann Otol Rhinol Laryngol. 108(4):378-83, 1999
                                                                                  23. Davis S et al: Effect of continuous positive airway pressure on forced expiratory flows in infants with tracheomalacia. Am J Respir Crit Care Med. 158(1):148-52, 1998
                                                                                  24. Paston F et al: Tracheomalacia. Pediatr Rev. 17(9):328, 1996
                                                                                  25. Jacobs IN et al: Tracheobronchomalacia in children. Arch Otolaryngol Head Neck Surg. 120(2):154-8, 1994
                                                                                  26. Mair EA et al: Pediatric tracheobronchomalacia and major airway collapse. Ann Otol Rhinol Laryngol. 101(4):300-9, 1992
                                                                                  27. Miller RW et al: Effectiveness of continuous positive airway pressure in the treatment of bronchomalacia in infants: a bronchoscopic documentation. Crit Care Med. 14(2):125-7, 1986
                                                                                  28. Holinger LD: Etiology of stridor in the neonate, infant and child. Ann Otol Rhinol Laryngol. 89(5 Pt 1):397-400, 1980