Tracheomalacia: our ten years experience in Milan

Tracheomalacia(TM) is an anomaly of upper respiratory tract characterized by weakness of tracheal walls associated with dynamic collapse during breathing. Tracheo-bronchomalacia(TBM) is the extension of this anomaly to part of bronchial walls.There are many causes of both congenital and acquired TBM: idiophatic, intrinsic defect of cartilagineous portion of the trachea; cardiovascular anomalies or extrinsic compression by heart and vessels anomalies, tumors, lymphonodes or masses; syndromes; prolonged positive pressure ventilation in premature infants with broncho-pulmonary dysplasia. Furthermore it can be a complication of surgical repair of esophageal atresia and trecheoesophageal fistula.In the last 10 years 44 patients followed by our department received the diagnosis of tracheomalacia or bronchomalacia, or both of them. In 54% of cases isolated tracheomalacia was found, in 16% isolated bronchomalacia, whereas in 30% a combination of both of them.In our series 18% of cases was idiopathic; 54% was affected by cardiovascular anomalies; 27% had esophageal atresia; 27% congenital syndromes and 14% was affected by gastro-esophageal reflux.13 patients affected by syndromes like VACTERL or previously operated for esophageal atresia, underwent surgery approach, because of TM life-threatening events and severe symptoms. Aortopexy was the most frequent approach (performed in 8 patients), with improvement of symptoms in the short term, but necessity of therapy with CPAP later in 1/1...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric bronchology Source Type: research