Children's Hospital Colorado

Tracheomalacia

What is tracheomalacia?

The trachea (or windpipe) is a major part of the respiratory system, carrying air in and out of the body. It is supported by several rings of cartilage that help it stay open when we exhale so air can leave the body. Tracheomalacia occurs if the cartilage cannot support the opening, which can close to half of its normal size or smaller.  

Tracheomalacia is often seen between 4 and 8 weeks of age, when babies start to breathe enough air to produce a wheezing sound. Babies are typically born with the condition but usually do not have symptoms in the first month of life. Sometimes, a child can develop tracheomalacia later in infancy or childhood.

Tracheomalacia is often benign and many children will outgrow it. It often occurs with other conditions, including tracheoesophageal fistula, chronic lung disease of infancy and aspiration from gastroesophageal reflux. However, tracheomalacia can cause ongoing, sometimes severe issues with cough, recurrent wheeze, pneumonia and apnea.

What causes tracheomalacia?

Tracheomalacia has multiple causes, but most children are born with the condition. Children who have defects in the cartilage in their trachea have Type 1 tracheomalacia. If a child's tracheomalacia is due to other causes of airway compression, like abnormally formed or malfunctioning blood vessels in their trachea, it is Type 2 tracheomalacia. This is common after the repair of a tracheoesophageal fistula (TEF) or abnormal blood vessel problems (vascular ring) in the chest.

Who gets tracheomalacia?

There is no way to predict who will have tracheomalacia. It occurs evenly in males and females and in all races. Evidence suggests that it is not genetic, so there are no tests that can be run on parents to determine if their child will have it.

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