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Tracheobronchomalacia in children
I N Jacobs1, R F Wetmore, L W Tom
1Department of Otolaryngology, Children's Hospital of Philadelphia, Pa.
Insights
Tracheobronchomalacia (TBM) is a common infant airway issue that typically resolves naturally. Most infants with TBM can be decannulated without surgery, indicating a self-limited disease course.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Pediatric Surgery
Background:
- Tracheobronchomalacia (TBM) is a significant cause of infant airway distress.
- TBM often resolves spontaneously as the infant airway grows.
Purpose of the Study:
- To investigate the origin and natural history of tracheobronchomalacia (TBM).
- To assess the long-term outcomes for infants diagnosed with TBM.
Main Methods:
- Retrospective chart review and telephone survey of 50 pediatric patients with TBM.
- Analysis of diagnostic bronchoscopy findings and treatment interventions.
Main Results:
- TBM is a common airway abnormality, identified in 15% of diagnostic bronchoscopies.
- Prematurity, low birth weight, bronchopulmonary dysplasia, and prolonged ventilation are risk factors for severe TBM.
- 71% of patients were decannulated without further surgery, remaining largely asymptomatic.
Conclusions:
- Tracheobronchomalacia (TBM) is generally a self-limited condition in infants.
- Most cases of TBM resolve without surgical intervention.
- Associated airway lesions can complicate decannulation in some TBM patients.
Abstract:
Tracheobronchomalacia (TBM) is an important cause of airway distress during infancy, but it generally resolves as the airway enlarges. To assess the origin and natural history of TBM, a chart review and telephone survey were conducted for 50 patients with TBM at the Children's Hospital of Philadelphia (Pa). This study revealed that TBM is a relatively common airway abnormality and is found on 15% of all diagnostic bronchoscopies. Prematurity, low birth weight, bronchopulmonary dysplasia, and prolonged ventilation predispose patients to the most severe symptoms. In our study, a tracheotomy with continuous positive airway pressure was required by 75% of the premature infants and 25% of the full-term infants with TBM. Seventy-one percent of all patients underwent decannulation without any other surgical intervention and remained nearly asymptomatic. Some patients could not undergo decannulation because of other airway lesions. In most instances, TBM is a self-limited disease that resolves without surgery.