Introduction:
Airway malacia is a condition of excessive airway collapsibility, which
causes expiratory reduction in the cross-sectional luminal area during
respiration. Lower airway malacia is classified as tracheomalacia (TM),
bronchomalacia (BM) or tracheobronchomalacia (TBM) according to the
localization of the malacic segment. Clinical presentation includes
stridor or wheeze, brassy cough, recurrent or prolonged respiratory
infections, atelectasis and even near-death attacks such as dying spell1.
Although this disorder has been known for a long time in paediatric
patients, the true incidence of lower airway malacia is still not well
known. With increasing bronchoscopic evaluation in paediatric patients,
developing devices of suitable size for small children and using
advanced imaging methods, lower airway malacia disorders are becoming
well recognized. Nevertheless, there is no universally agreed gold
standard diagnostic test for lower airway malacia.
After diagnosing a child with malacia, clinicians encounter new
challenges, as there is no consensus on disease management related to
scarcity of the evidence-based studies in the literature. While
tracheostomy with or without invasive mechanical ventilation (MV) was
the mainstay of treatment for severe TM in the past, this treatment
modality was recently replaced mostly by medical therapy with
non-invasive positive pressure support.
In this study, we aimed to review the medical data of the patients with
lower airway malacia diagnosed by flexible bronchoscopy and followed in
our centre, in terms of clinical and radiological features, prognoses,
and associated disorders of the patients.