Chest
ReviewsTracheomalacia and Tracheobronchomalacia in Children and Adults: An In-depth Review
Section snippets
History
The earliest references to the disease we now call TM are from the 1930s and 1940s, when clinicians described congenital thoracic vascular abnormalities that resulted in tracheal obstruction.9, 10, 11In 1948, Gross and Neuhauser12 described an infant with cough, wheezing, cyanosis, and spontaneous hyperextension of the head. Her trachea was compressed by an anomalous innominate artery that, despite surgical correction, had structurally deformed the trachea. One year later, Evans13 described
History
In 1897, Czyhlarz156 was the first to describe the postmortem finding of an unusually large trachea and bronchi. The first clinical report of isolated tracheal enlargement in an adult was by Mounier-Kuhn157 in 1932. Lemoine158 was the first to use bronchoscopy to document acquired tracheal enlargement in the adult in 1949. Additional case reports159, 160, 161of TM in adults began to appear in the 1950s. Ferraris161 described two patients with acquired TM who both reported “expiratory dyspnea,”
Conclusion
TM and TBM are becoming more commonly recognized and treated in children and adults. The causes and, therefore, the treatments vary, so a working knowledge of the options is important. Noninvasive imaging technology is increasingly being employed for diagnosis, and novel treatments, such as definitive surgical placation and stabilization with removable stents, are becoming alternatives to conservative interventions, such as CPAP. As a result of the complexity of these conditions and the options
Acknowledgments
The authors thank Simon Ashiku, MD (Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, MA), Carl O'Donnell, ScD, MPH (Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center), and David Feller-Kopman (Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center) for their help in the preparation of this article.
References (243)
- et al.
Acquired tracheomalacia: etiology and differential diagnosis
Chest
(1975) - et al.
Life-threatening anoxic spells caused by tracheal compression after repair of esophageal atresia: correction by surgery
J Pediatr Surg
(1976) Syndrome of constricting double aortic arch in infancy: report of a case
J Pediatr
(1939)- et al.
Treatment of tracheomalacia: eight years' experience
J Pediatr Surg
(1986) - et al.
Congenital chondromalacia of the trachea
J Thorac Cardiovasc Surg
(1965) - et al.
Tracheobronchomalacia in Hunter's syndrome
Int J Pediatr Otorhinolaryngol
(1993) - et al.
Contemporary surgery of tracheomalacia
J Pediatr Surg
(1986) - et al.
Tracheal compression by the innominate artery in children
Ann Thorac Surg
(1969) - et al.
Primary tracheomalacia
Ann Thorac Surg
(1983) - et al.
Anterior cricoid suspension and tracheal stomal closure for children with cricoid collapse and peristomal tracheomalacia following tracheostomy
J Pediatr Surg
(1993)