Introduction:
Airway malacia is a condition of excessive airway collapsibility, which causes expiratory reduction in the cross-sectional luminal area during respiration. Lower airway malacia is classified as tracheomalacia (TM), bronchomalacia (BM) or tracheobronchomalacia (TBM) according to the localization of the malacic segment. Clinical presentation includes stridor or wheeze, brassy cough, recurrent or prolonged respiratory infections, atelectasis and even near-death attacks such as dying spell1.
Although this disorder has been known for a long time in paediatric patients, the true incidence of lower airway malacia is still not well known. With increasing bronchoscopic evaluation in paediatric patients, developing devices of suitable size for small children and using advanced imaging methods, lower airway malacia disorders are becoming well recognized. Nevertheless, there is no universally agreed gold standard diagnostic test for lower airway malacia.
After diagnosing a child with malacia, clinicians encounter new challenges, as there is no consensus on disease management related to scarcity of the evidence-based studies in the literature. While tracheostomy with or without invasive mechanical ventilation (MV) was the mainstay of treatment for severe TM in the past, this treatment modality was recently replaced mostly by medical therapy with non-invasive positive pressure support.
In this study, we aimed to review the medical data of the patients with lower airway malacia diagnosed by flexible bronchoscopy and followed in our centre, in terms of clinical and radiological features, prognoses, and associated disorders of the patients.