Tracheomalacia is a condition characterized by flaccidity of the trachea

Vertebrate trachea

In tetrapod anatomy the trachea, or windpipe, is a tube that connects the pharynx or larynx to the lungs, allowing the passage of air. It is lined with pseudostratified ciliated columnar epithelium cells with goblet cells that produce mucus...

l support cartilage

Cartilage

Cartilage is a flexible connective tissue found in many areas in the bodies of humans and other animals, including the joints between bones, the rib cage, the ear, the nose, the elbow, the knee, the ankle, the bronchial tubes and the intervertebral discs...

 which leads to tracheal collapse especially when increased airflow is demanded.

The trachea normally dilates slightly during inspiration

Inhalation

Inhalation is the movement of air from the external environment, through the air ways, and into the alveoli....

 and narrows slightly during expiration

Exhalation

Exhalation is the movement of air out of the bronchial tubes, through the airways, to the external environment during breathing....

. These processes are exaggerated in tracheomalacia, leading to airway collapse on expiration. The usual symptom of tracheomalacia is expiratory stridor

Stridor

Stridor is a high pitched wheezing sound resulting from turbulent air flow in the upper airway. Stridor is a physical sign which is produced by narrow or obstructed airway path. It can be inspiratory, expiratory or biphasic . Inspiratory stridor is common...

 or laryngeal crow.

If the condition extends further to the bronchi (if there is also bronchomalacia

Bronchomalacia

Bronchomalacia is a term for weak cartilage in the walls of the bronchial tubes, occurring in children under six months, presented with noisy breathing and/or wheezing. There is collapse of a main stem bronchus, on expiration. There are two types of Bronchomalacia. Primary Bronchomalacia is due to...

), it is termed tracheobronchomalacia

Tracheobronchomalacia

Tracheobronchomalacia or TBM is a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse with condition extends further to the bronchi....

. The same condition can also affect the larynx

Larynx

The larynx , commonly called the voice box, is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume...

, which is called laryngomalacia

Laryngomalacia

Laryngomalacia is a very common condition of infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction. It can also be seen in older patients, especially those with neuromuscular conditions resulting in weakness of the...

.

Classification

There are three types:

• Type 1 — congenital, sometimes associated with tracheoesophageal fistula
  Tracheoesophageal fistula
  A tracheoesophageal fistula is an abnormal connection between the esophagus and the trachea...
  
   or esophageal atresia
  Esophageal atresia
  Esophageal atresia is a congenital medical condition which affects the alimentary tract. It causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach. It comprises a variety of congenital anatomic defects that are caused by an abnormal embryological...
  
  
• Type 2 — extrinsic compression sometimes due to vascular ring
  Vascular ring
  A vascular ring is a congenital defect in which there is an abnormal formation of the aorta and/or its surrounding blood vessels. The trachea and esophagus are completely encircled and sometimes compressed by a "ring" formed by these vessels, which can lead to breathing and digestive...
  
  s
• Type 3 — acquired due to chronic
  Chronic (medicine)
  A chronic disease is a disease or other human health condition that is persistent or long-lasting in nature. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include asthma, cancer, diabetes and HIV/AIDS.In medicine, the...
  
   infection or prolonged intubation
  Intubation
  Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic or rubber tube into the trachea to maintain an open airway or to serve as a conduit through which to administer certain drugs...
  
   or inflammatory conditions like relapsing polychondritis
  Polychondritis
  Relapsing polychondritis is a condition characterized by deterioration of cartilage....
  
  

Treatment

If the symptoms are severe enough, treatment may be needed. These range from medical management over mechanical ventilation

Mechanical ventilation

In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. This may involve a machine called a ventilator or the breathing may be assisted by a physician, respiratory therapist or other suitable person compressing a bag or set of bellows...

 (both continuous positive airway pressure

Continuous positive airway pressure

Positive airway pressure is a mode of respiratory ventilation used primarily in the treatment of sleep apnea, for which it was first developed. PAP ventilation is also commonly used for those who are critically ill in hospital with respiratory failure, and in newborn infants...

, CPAP, or bi-level positive airway pressure, BiPAP) to tracheal stenting and surgery

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

.

Surgical techniques include aortopexy

Aortopexy

Aortopexy is a surgical procedure in which the aortic arch is fixated to the sternum. It results in the tracheal lumen being pulled open. It is used to treat severe tracheomalacia or tracheal compression....

, tracheopexy, tracheobronchoplasty

Tracheobronchoplasty

A tracheobronchoplasty is an experimental procedure performed at limited medical facilities across the United States. It consists of a thoracic surgery during which mesh is sutured to the outside of the patient's trachea through a series of hundreds of knots...

, and tracheostomy. None of these techniques have been shown to be more effective than the other.