Health Library

Tracheomalacia

What are the Causes of Tracheomalacia?

Most often, tracheomalacia is congenital. This means the child was born with the condition.

Other types can occur later when something presses on the tracheal cartilage, such as a blood vessel that crosses too closely to the trachea, putting pressure on the walls of the airway. Tracheomalacia can also develop after a child has been on a ventilator for quite a long time. These two causes are much less common than the congenital type.

Babies born with tracheomalacia may have other congenital abnormalities such as heart defects, developmental delay, esophageal abnormalities or gastroesophageal reflux (GERD).

What are the Symptoms of Tracheomalacia?

• Noisy breathing that may change with position and improve during sleep
• Cough or noisy breathing that gets worse with activity
• Breathing problems that get worse with coughing, crying, feeding or upper respiratory infections
• High-pitched breathing or rattling during breathing
• Frequent lung infections such as bronchitis or pneumonia

How Do You Diagnose Tracheomalacia?

A physical exam can confirm the symptoms. A chest X-ray may show narrowing of the trachea, but often the X-ray is normal. A bronchoscopy, which lets a doctor see down into the airway, can confirm the diagnosis. Other tests may include:

• Airway fluoroscopy
• Video barium swallow study
• CT scan
• Lung function tests
• Magnetic resonance imaging (MRI)

What is the Treatment for Tracheomalacia?

Tracheomalacia can be mild enough to not need any treatment. It can also be moderate or severe (life-threatening). Most children with this condition will either outgrow it by the time they turn 2 or have symptoms that are not severe enough to need surgery.

Most often, symptoms improve as a child grows. Only severe cases need surgery. Most infants respond well to humidified air, careful feedings, and antibiotics for infections. Babies with this condition must be closely watched when they have respiratory infections.

Congenital tracheomalacia most often goes away on its own by the age of 18-24 months. As the tracheal cartilage gets stronger and grows, over time, the noisy breathing problems stop.