نظرة عامة
Tracheomalacia (tray-key-oh-muh-LAY-shuh) is the collapse or falling in of the trachea. The trachea, also called the windpipe, is the tube that brings air from the mouth and nose to the lungs. Firm rings made of cartilage hold the windpipe open during breathing. Tracheomalacia occurs most often in babies, when the cartilage in the windpipe has not developed as it should. This soft cartilage makes the windpipe floppy, so it's not stiff enough to keep the airway open.
Another cause of tracheomalacia is when a blood vessel presses on the windpipe so that it can't open enough with breathing. Less often, tracheomalacia affects older children and adults.
Tracheomalacia can be life-threatening and make it difficult to breathe. Trouble breathing can make it hard to be active. Also, the collapse can cause repeated airway and lung infections.
Your child may not need treatment if tracheomalacia symptoms are mild. Symptoms sometimes improve on their own as a child grows and the windpipe gets stronger. If symptoms are more serious and limit a child's quality of life, medicine, therapy and surgery can help.
الأعراض
Symptoms can range from mild to severe. Symptoms may be seen at birth, but they may be mild and not noticed until an infant is about 4 to 8 weeks old. Symptoms may get worse when a child is eating. Symptoms include:
- Coughing often. The cough may sound like a barking seal.
- Noisy breathing, such as high-pitched wheezing or rattling sounds.
- Trouble getting enough air that gets worse with crying, coughing, eating or activity.
- Trouble clearing mucus from the airway.
- Frequent infections in the airway, such as pneumonia or bronchitis.
- Trouble swallowing or eating.
- Shortness of breath when active, for example, playing with other children or playing sports.
Tracheomalacia may affect the whole windpipe or only a small section. When tracheomalacia includes the airways in the lungs, also known as the bronchi, it's called tracheobronchomalacia (tray-key-oh-brong-koh-muh-LAY-shuh).
When to see a doctor
If you have concerns about your child's growth and development, talk with your healthcare professional.
Make an appointment with a healthcare professional if your child has:
- Trouble with breathing, such as making high-pitched wheezing or grunting noises when breathing.
- Trouble with choking when eating.
- Lost weight or is not gaining enough weight.
Go to the emergency room at a hospital if your child:
- Has trouble breathing and can't speak or cry.
- Can't breathe easily and the ribs seem to suck inward when breathing in.
- Has short stops in breathing.
- Has blue or gray skin, lips and fingernails due to low oxygen levels. Depending on skin color, these changes may be harder or easier to see.
- Seems slow moving, weak or very tired.
الأسباب
Causes of tracheomalacia include:
- A trachea that is not fully developed. In newborns, the cartilage may not be developed enough. The soft cartilage causes the windpipe to be floppy. The windpipe doesn't stay open when breathing.
- Changes in how the trachea develops. In some infants the trachea doesn't develop in the typical way. For example, it might not have enough cartilage. Some infants are born with an opening between the esophagus — the tube that goes from the mouth to the stomach — and the trachea. This can cause tracheomalacia. Changes can make the windpipe more likely to collapse when breathing.
- Pressure on the trachea from a blood vessel. A blood vessel, such as the aorta or the main branches of the aorta, may press on the windpipe so it doesn't open enough with breathing.
- Damage to the trachea from injury or illness. For example, the windpipe can be damaged from surgery or medical procedures or from having a breathing tube for a long time. Examples of illnesses that can damage the windpipe include chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD) and frequent lung infections.
عوامل الخطورة
Risk factors for tracheomalacia include:
- Being born too early. The windpipe may not be fully developed in infants born too early. The cartilage is not strong enough to hold the airway open.
- Differences in main blood vessels. These blood vessels bring blood from the heart to the rest of the body. Pressure on the windpipe from these blood vessels increases the risk of tracheomalacia.
- Being born with a passage between the trachea and the esophagus. The opening, called a tracheoesophageal fistula, can increase the risk of tracheomalacia.
- Injury to the windpipe. Surgery, medical procedures or having a breathing tube for a long time can injure the windpipe so that it collapses with breathing.
- Illnesses that affect the windpipe. Having frequent airway and lung infections, such as bronchitis and pneumonia, can irritate and weaken the windpipe. GERD also can irritate and weaken the windpipe.
المضاعفات
Tracheomalacia can be life-threatening if severe. It can result in:
- Low oxygen in the body.
- Blue or gray skin color due to low oxygen levels. Depending on skin color, these changes may be harder or easier to see.
- Short stops in breathing.
- Choking during eating.
- Losing weight or not gaining enough weight.
- Breathing trouble with activity.
- Severe and frequent lung infections.
Infants born with tracheomalacia may have other conditions at birth. These can include changes in the development of the heart, lungs or esophagus.