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Tracheomalacia/Laryngomalacia is a topic covered in the Select 5-Minute Pediatrics Topics.

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  • Malacia refers to “softness” of airway structures.
  • Laryngomalacia
    • Dynamic collapse of the supraglottic structures of the larynx resulting in airway obstruction
    • Most common congenital anomaly of the larynx
    • Most common noninfectious cause of stridor in children
  • Tracheomalacia
    • Dynamic collapse of the trachea resulting in airway obstruction
    • Common cause of chronic wheezing in infants and children
    • Clinical manifestations depend on if lesion is part of the intrathoracic or extrathoracic portions of the trachea.


  • Laryngomalacia
    • Anatomic abnormalities:
      • Short aryepiglottic folds
      • Elongated, flaccid, omega-shaped epiglottis prolapses posteriorly.
      • Redundant arytenoid mucosa
    • Neurologic abnormalities:
      • Immaturity of neuromuscular control results in hypotonia of pharyngeal muscles.
  • Tracheomalacia
    • Weakness of the tracheal wall secondary to softening of the anterior cartilaginous rings and/or decreased tone of the posterior membranous wall
    • Classified as primary or secondary
      • Primary: congenital; results from immature development of the tracheal structures; may occur with other congenital anomalies such as tracheoesophageal fistula, laryngomalacia, and facial anomalies
      • Secondary: acquired in a normally developed trachea after some insult such as prolonged positive pressure ventilation, recurrent infection or aspiration, or external compression
    • During exhalation, increased collapsing pressure across a compliant airway wall causes invagination of the posterior membrane.
    • With increasing age, the length, area, thickness, and amount of cartilage increases in the anterior rings as well as the size and contractility of the membranous wall.

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Cabana, Michael D., editor. "Tracheomalacia/Laryngomalacia." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. 5minute, www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia.
Tracheomalacia/Laryngomalacia. In: Cabana MD, ed. Select 5-Minute Pediatrics Topics. 7th ed. Wolters Kluwer Health; 2015. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia. Accessed July 22, 2019.
Tracheomalacia/Laryngomalacia. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics. Available from https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia
Tracheomalacia/Laryngomalacia [Internet]. In: Cabana MD, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2019 July 22]. Available from: https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia.
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TY - ELEC T1 - Tracheomalacia/Laryngomalacia ID - 14129 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14129/all/Tracheomalacia_Laryngomalacia PB - Wolters Kluwer Health ET - 7 DB - 5minute DP - Unbound Medicine ER -