Tracheomalacia: Difference between revisions
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==Treatment== |
==Treatment== |
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Life is usually saved if the airway is opened via a hole in the throat. If a person survives, they may have symptoms, but usually will get better after the airway is reopened. If the symptoms are severe enough, treatment may be needed. These range from medical management over [[mechanical ventilation]] (both [[continuous positive airway pressure]] (CPAP), or [[bi-level positive airway pressure]] (BiPAP) to [[tracheal stenting]] and [[surgery]]. |
Life is usually saved if the airway is opened via a hole in the throat. If a person survives, they may have symptoms, but usually will get better after the airway is reopened. If the symptoms are severe enough, treatment may be needed. These range from medical management over [[mechanical ventilation]] (both [[continuous positive airway pressure]] (CPAP), or [[bi-level positive airway pressure]] (BiPAP) to [[tracheal stenting]] and [[surgery]].{{cn}} |
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Surgical techniques include [[aortopexy]], [[tracheopexy]], [[tracheobronchoplasty]], and [[tracheostomy]].<ref name="pmid17356936">{{cite journal |vauthors=van der Zee DC, Bax NM |title=Thoracoscopic tracheoaortopexia for the treatment of life-threatening events in tracheomalacia |journal=Surgical Endoscopy |volume=21 |issue=11 |pages=2024–2025 |year=2007 |pmid=17356936 |doi=10.1007/s00464-007-9250-8|doi-access=free }}</ref><ref>{{Cite journal|last=Goyal|first=Vikas|last2=Masters|first2=I. Brent|last3=Chang|first3=Anne B.|date=2012-10-17|title=Interventions for primary (intrinsic) tracheomalacia in children|journal=The Cochrane Database of Systematic Reviews|volume=10|pages=CD005304|doi=10.1002/14651858.CD005304.pub3|issn=1469-493X|pmid=23076914|url=http://espace.library.uq.edu.au/view/UQ:288028/UQ288028_OA.pdf}}</ref> The role of the nebulised recombinant human deoxyribonuclease (rhDNase) remains inconclusive.<ref>{{Cite journal|last=Goyal|first=Vikas|last2=Masters|first2=I. Brent|last3=Chang|first3=Anne B.|date=2012-10-17|title=Interventions for primary (intrinsic) tracheomalacia in children|journal=The Cochrane Database of Systematic Reviews|volume=10|pages=CD005304|doi=10.1002/14651858.CD005304.pub3|issn=1469-493X|pmid=23076914|url=http://espace.library.uq.edu.au/view/UQ:288028/UQ288028_OA.pdf}}</ref> |
Surgical techniques include [[aortopexy]], [[tracheopexy]], [[tracheobronchoplasty]], and [[tracheostomy]].<ref name="pmid17356936">{{cite journal |vauthors=van der Zee DC, Bax NM |title=Thoracoscopic tracheoaortopexia for the treatment of life-threatening events in tracheomalacia |journal=Surgical Endoscopy |volume=21 |issue=11 |pages=2024–2025 |year=2007 |pmid=17356936 |doi=10.1007/s00464-007-9250-8|doi-access=free }}</ref><ref>{{Cite journal|last=Goyal|first=Vikas|last2=Masters|first2=I. Brent|last3=Chang|first3=Anne B.|date=2012-10-17|title=Interventions for primary (intrinsic) tracheomalacia in children|journal=The Cochrane Database of Systematic Reviews|volume=10|pages=CD005304|doi=10.1002/14651858.CD005304.pub3|issn=1469-493X|pmid=23076914|url=http://espace.library.uq.edu.au/view/UQ:288028/UQ288028_OA.pdf}}</ref> The role of the nebulised recombinant human deoxyribonuclease (rhDNase) remains inconclusive.<ref>{{Cite journal|last=Goyal|first=Vikas|last2=Masters|first2=I. Brent|last3=Chang|first3=Anne B.|date=2012-10-17|title=Interventions for primary (intrinsic) tracheomalacia in children|journal=The Cochrane Database of Systematic Reviews|volume=10|pages=CD005304|doi=10.1002/14651858.CD005304.pub3|issn=1469-493X|pmid=23076914|url=http://espace.library.uq.edu.au/view/UQ:288028/UQ288028_OA.pdf}}</ref> |
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Revision as of 18:22, 20 November 2020
| Tracheomalacia | |
|---|---|
| Specialty | Pulmonology  |
| Prevention | Avoiding hard throat impacts |
Tracheomalacia is a condition or incident where the cartilage that keeps the airway (trachea) open is soft such that the trachea partly collapses especially during increased airflow. The usual symptom is stridor when a person breathes out. This is usually known as a collapsed windpipe.
The trachea normally opens slightly during breathing in and narrows slightly during breathing out. These processes are exaggerated in tracheomalacia, leading to airway collapse on breathing out.
If the condition extends further to the large airways (bronchi) (if there is also bronchomalacia), it is termed tracheobronchomalacia. The same condition can also affect the larynx, which is called laryngomalacia. The term is from trachea and the Greek μαλακία, softening
Signs and symptoms
Tracheomalacia occurs when the walls of the trachea collapse. This can happen because the walls of the windpipe are weak, or it can happen because something is pressing on it. The whole windpipe can be affected, or only a short piece of it. If the collapsed part of the windpipe goes past the area where the windpipe branches off into the two lungs, it is called bronchomalacia.[citation needed]
This problem causes noisy or difficult breathing in the first 1 to 2 months after birth. This is called congenital tracheomalacia (it was present at birth). It is not very common. Babies born with tracheomalacia may have other health issues like a heart defect, reflux or developmental delay. Some children get tracheomalacia because of other health issues. Symptoms can be mild to severe.[citation needed]
Symptoms inside the lung include noisy breathing that may get better when you change your baby's position or while he or she is asleep. Breathing problems that get worse during coughing, crying, feeding or colds. High-pitched sound during breathing (stridor). High-pitched cough. Rattling noise or wheezing with breathing.[citation needed]
Diagnosis
Classifications
There are three types of tracheomalacia:[1]
- Type 1—congenital, sometimes associated with tracheoesophageal fistula or esophageal atresia
- Type 2—extrinsic compression sometimes due to vascular rings
- Type 3—acquired due to chronic infection or prolonged intubation or inflammatory conditions like relapsing polychondritis
Treatment
Life is usually saved if the airway is opened via a hole in the throat. If a person survives, they may have symptoms, but usually will get better after the airway is reopened. If the symptoms are severe enough, treatment may be needed. These range from medical management over mechanical ventilation (both continuous positive airway pressure (CPAP), or bi-level positive airway pressure (BiPAP) to tracheal stenting and surgery.[citation needed]
Surgical techniques include aortopexy, tracheopexy, tracheobronchoplasty, and tracheostomy.[2][3] The role of the nebulised recombinant human deoxyribonuclease (rhDNase) remains inconclusive.[4]
See also
- Tracheal collapse for the condition in dogs
References
- ^ Austin J, Ali T (January 2003). "Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management". Paediatr Anaesth. 13 (1): 3–11. doi:10.1046/j.1460-9592.2003.00802.x. PMID 12535032.
- ^ van der Zee DC, Bax NM (2007). "Thoracoscopic tracheoaortopexia for the treatment of life-threatening events in tracheomalacia". Surgical Endoscopy. 21 (11): 2024–2025. doi:10.1007/s00464-007-9250-8. PMID 17356936.
- ^ Goyal, Vikas; Masters, I. Brent; Chang, Anne B. (2012-10-17). "Interventions for primary (intrinsic) tracheomalacia in children" (PDF). The Cochrane Database of Systematic Reviews. 10: CD005304. doi:10.1002/14651858.CD005304.pub3. ISSN 1469-493X. PMID 23076914.
- ^ Goyal, Vikas; Masters, I. Brent; Chang, Anne B. (2012-10-17). "Interventions for primary (intrinsic) tracheomalacia in children" (PDF). The Cochrane Database of Systematic Reviews. 10: CD005304. doi:10.1002/14651858.CD005304.pub3. ISSN 1469-493X. PMID 23076914.