Tracheomalacia - acquiredSecondary tracheomalacia
Acquired tracheomalacia is a weakness and floppiness of the walls of the windpipe (trachea, or airway). It develops after birth.
Congenital tracheomalacia is a related topic.
Congenital tracheomalacia is weakness and floppiness of the walls of the windpipe (trachea). Congenital means it is present at birth.
Acquired tracheomalacia is very uncommon at any age. It occurs when normal cartilage in the wall of the windpipe begins to break down.
This form of tracheomalacia may result:
- When large blood vessels put pressure on the airway
- As a complication after surgery to repair birth defects in the windpipe and esophagus (the tube that carries food from the mouth to the stomach)
- After having a breathing tube or trachea tube (tracheostomy) for a long time
Symptoms of tracheomalacia include:
- Breathing problems that get worse with coughing, crying, or upper respiratory infections, such as a cold
- Breathing noises that may change when body position changes, and improve during sleep
- High-pitched breathing
- Rattling, noisy breaths
Exams and Tests
A physical exam confirms the symptoms. A chest x-ray may show narrowing of the trachea when breathing out. Even if the x-ray is normal, it is needed to rule out other problems.
A procedure called a laryngoscopy is used to diagnose the condition. This procedure allows the otolaryngologist (ear, nose, and throat doctor, or ENT) to see the structure of the airway and determine how severe the problem is.
Laryngoscopy is an exam of the voice box (larynx). It can be done using a small mirror held just below the back of your palate, or a rigid or flexib...
Other tests may include:
- Airway fluoroscopy
- Barium swallow
- CT scan
- Lung function tests
- Magnetic resonance imaging (MRI)
The condition may improve without treatment. However, people with tracheomalacia must be monitored closely when they have respiratory infections.
Continuous positive airway pressure
Positive airway pressure (PAP) treatment uses a machine to pump air under pressure into the airway of the lungs. This helps keep the windpipe open d...
A stent is a tiny tube placed into a hollow structure in your body. This structure can be an artery, a vein, or another structure such as the tube t...
Aspiration pneumonia (a lung infection) can occur from breathing in food.
Pneumonia is a breathing condition in which there is swelling or an infection of the lungs or large airways. Aspiration pneumonia occurs when food, ...
Adults who develop tracheomalacia after being on a breathing machine often have serious lung problems.
When to Contact a Medical Professional
Call your health care provider if you or your child breathes in an abnormal way. Tracheomalacia can become an urgent or emergency condition.
Finder JD. Bronchomalacia and tracheomalacia. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 416.
Little BP. Tracheal diseases. In: Walker CM, Chung JH, eds. Muller's Imaging of the Chest. 2nd ed. Philadelphia, PA: Elsevier; 2019:chap 56.
Nelson M, Green G, Ohye RG. Pediatric tracheal anomalies. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 206.
Respiratory system overview - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system overview
Review Date: 5/17/2019
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.