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.
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Citation
Cabana, Michael D., editor. "Tracheomalacia/Laryngomalacia." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617305/all/Tracheomalacia_Laryngomalacia.
Tracheomalacia/Laryngomalacia. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617305/all/Tracheomalacia_Laryngomalacia. Accessed December 4, 2024.
Tracheomalacia/Laryngomalacia. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617305/all/Tracheomalacia_Laryngomalacia
Tracheomalacia/Laryngomalacia [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 December 04]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617305/all/Tracheomalacia_Laryngomalacia.
* Article titles in AMA citation format should be in sentence-case
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T1 - Tracheomalacia/Laryngomalacia
ID - 617305
ED - Cabana,Michael D,
BT - 5-Minute Pediatric Consult
UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617305/all/Tracheomalacia_Laryngomalacia
PB - Wolters Kluwer
ET - 8
DB - Pediatrics Central
DP - Unbound Medicine
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