Chapter 381 Bronchomalacia and Tracheomalacia
Chondromalacias of the trachea or of a main bronchus occur when there is insufficient cartilage to maintain airway patency throughout the respiratory cycle and are common causes of persistent wheezing in infancy. Tracheomalacia and bronchomalacia can be either primary or secondary (see Table 381-1 on the Nelson Textbook of Pediatrics website at www.expertconsult.com). Although primary tracheomalacia and bronchomalacia are often seen in premature infants, most affected patients are born at term. Secondary tracheomalacia and bronchomalacia refers to the situation in which the central airway is compressed by adjacent structure (e.g., vascular ring, Chapter 426) or deficient in cartilage due to tracheoesophageal fistula. Laryngomalacia can accompany primary bronchomalacia or tracheomalacia. Involvement of the entire central airway (laryngotracheobronchomalacia) is also seen.
Table 381-1 CLASSIFICATION OF TRACHEOMALACIA
PRIMARY TRACHEOMALACIA
SECONDARY TRACHEOMALACIA
From McNamara VM, Crabbe DC: Tracheomalacia, Paediatr Respir Rev 5:147–154, 2004.