A Retrospective Analysis of Children with Lower Airway Malacia in a
Tertiary Paediatric Hospital
Abstract
Background: Airway malacia is a condition of excessive airway
collapsibility, which causes expiratory reduction in the cross-sectional
luminal area during respiration. As this disorder may lead to life
threatening events and even death in children, it is important to
recognise and treat it. Aims: In this study, we aimed to evaluate
clinical and radiological features, prognoses, and associated disorders
of the patients with lower airway malacia. Methods: A total of 65
patients with lower airway malacia diagnosed by flexible bronchoscopy
were included in this study. Demographic and clinical features,
radiological findings, video image records of bronchoscopy and prognoses
of the patients were evaluated retrospectively. Results: Lower airway
malacia was diagnosed in 65 (16.6%) children with a median age of 1
year and 2 months (range: 1 month-16 years and 8 months). Thirty-five
(53.8%) of them were male. The numbers of children with isolated
tracheomalacia, isolated bronchomalacia and tracheobronchomalacia were
nine (13.8%), 48 (73.8%) and eight (12.3%), respectively. The most
common reason for admission was recurrent and/or prolonged respiratory
infection (46.2%) and the most common physical examination finding was
stridor (36.9%). Fifty-eight (89.2%) patients had other co-morbidities
associated with airway malacia. Inhaled ipratropium bromide therapy was
started for 37 (56.9%) patients. Ten (15.4%) patients required
continuous positive pressure support.. Conclusion: Lower airway malacia
is an important disorder in children with respiratory problems and
flexible bronchoscopy is a valuable diagnostic method. Sharing
experiences in terms of diagnosis and treatment modalities would help
patients as well as clinicians.