Tracheomalacia

Tracheomalacia is a disease which is characterized by a relaxation of the trachea. The reason for this lies in insufficient stability of the present in the trachea cartilage rings, which typically at the time of inhalation phase ( quite often but also the exhalation phase ) leads to a collapse of the trachea. The Tracheomalacia a segment or the entire trachea concern.

Pathogenesis

Since, in the inhalation phase, a negative pressure must be provided to allow the flow of air into the lungs, while the air tube with abnormally soft cartilaginous tissue collapses more easily, than in the exhalation phase. This means that preferably an inspiratory, but also very much a expiratory stridor occurs (both as a sign of increased airway resistance ). Ultimately, can be so high and the breathing be so strong that impairs the patient developed increasing dyspnea and ultimately stifled without proper treatment of airflow resistance.

Classification

There are three forms:

• Type 1: congenital, gain in the supine position
• Type 2: by external compression (eg, tumors or goiter) caused indentation of the trachea
• Type 3: due to chronic infection or excessively long intubation acquired instability

Treatment and prognosis

In congenital Tracheomalazien, it often enough and abdominal not to store the baby on her on the back. In most cases, there is a spontaneous healing tendency in the course of months and years. In a tracheomalacia by external compression, the cause is as far as possible to remove ( eg with a goitre by radioiodine therapy or thyroidectomy ). For infection- related Tracheomalacia a fair test antibiotic is indicated. Especially in the infection- related form, the prognosis is less favorable to the occurrence of tracheal stenosis is possible. As a last resort surgical enlargement of the trachea sculptures are possible.

If the tracheomalacia so pronounced that it limits the patient's breathing life threatening, so symptom- related measures must be taken to make adequate ventilation of the lungs is possible again. Depending on the degree of expression and localization of the affected trachea portions can satisfy a tracheotomy with subsequent placement of a tracheostomy tube. In special cases it may be necessary, however, that a tube to the bifurcation ( the point where the trachea is divided into left and right main ) is advanced.