Type 2 tracheomalacia; Type 3 tracheomalacia

Acquired tracheomalacia occurs when previously normal cartilage in the wall of the windpipe starts to break down.

There are two types of acquired tracheomalacia.

• Type 2 develops when there is pressure on the airway. This may be due to an abnormality of the blood vessels surrounding the trachea or a tumor in the neck or throat.
• Type 3 tracheomalacia results from long term use of a breathing tube (intubation) or repeated infections involving the trachea.

Acquired tracheomalacia is very uncommon.

• Breathing problems that get worse with coughing, crying, or upper respiratory infections
• Breathing noises that may change with position and improve during sleep
• High-pitched breathing
• Rattling, noisy breaths

A physical examination confirms the symptoms. A chest x-ray may show narrowing of the trachea when exhaling. Even if the x-ray is normal, it is needed to rule out other problems.

A procedure called a laryngoscopy provides the definitive diagnosis. 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.

Other tests that may be performed include:

• Airway fluoroscopy
• Barium swallow
• Bronchoscopy
• CT scan
• Lung function tests
• Magnetic resonance imaging (MRI)

Persons with tracheomalacia must be monitored closely when they have respiratory infections.

Continuous positive airway pressure (CPAP) may be necessary for adults with respiratory distress. Rarely, surgery is needed. A stent may be needed to hold the airway.