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Bronchomalacia is a term for weak cartilage in the walls of the bronchial tubes, often occurring in children under six months. Bronchomalacia means ‘floppiness’ of some part of the bronchi. Patients present with noisy breathing and/or wheezing. There is collapse of a main stem bronchus on exhalation. If the trachea is also involved the term tracheobronchomalacia (TBM) is used. If only the upper airway the trachea is involved it is called tracheomalacia (TM). There are two types of bronchomalacia. Primary bronchomalacia is due to a deficiency in the cartilaginous rings. Secondary bronchomalacia may occur by extrinsic compression from an enlarged vessel, a vascular ring or a bronchogenic cyst. Though uncommon, idiopathic (of unknown cause) tracheobronchomalacia has been described in older adults.

Description

Bronchomalacia can best be described as a birth defect of the bronchus in the respiratory tract. Congenital malacia of the large airways is one of the few causes of irreversible airways obstruction in children, with symptoms varying from recurrent wheeze and recurrent lower airways infections to severe dyspnea and respiratory insufficiency. It may also be acquired later in life due to chronic or recurring inflammation resulting from infection or other airway disease.^[1]^[2]^[3]^[4]^[5]

Classification

Primary Bronchomalacia
Secondary Bronchomalacia

Primary Bronchomalacia

Primary Bronchomalacia is classified as congenital.
Primary Bronchomalacia is caused by a deficiency in the cartilaginous rings.
Primary airway malacia was defined as airway malacia in otherwise normal infants.^[6]

Secondary Bronchomalacia

Secondary Bronchomalacia is acquired.
Secondary Bronchomalacia may occur by extrinsic compression from an enlarged vessel, a vascular ring or a bronchogenic cyst.
Secondary airway malacia was defined as airway malacia secondary to esophageal atresia, VATER/VACTERL association (condition with vertebral anomalies, anal atresia, congenital heart disease, tracheoesophageal fistula or esophageal atresia, renourinary anomalies, or radial limb defects), vascular or other external compression of the airways, or specific syndromes.

Diagnosis

Bronchoscopy

Treatment

Time
1. Minimally Invasive, usually in conjunction with Continuous Positive Airflow Pressure.
Continuous Positive Airflow Pressure
1. A method of respiratory ventilation.
Tracheotomy
1. Surgical procedures on the neck to open a direct airway through an incision in the trachea (the windpipe).
Prosthesis
1. Insertion of a prosthesis to keep the bronchial tube open.

Notes

^ Carden, KA, Boiselle, PM, Waltz, DA, et al. (2005) Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest 127,984-1005.
^ Clements, B Congenital malformations of the lungs and airways. Taussig, LM Landau, LI eds. Pediatric respiratory medicine 1999,1106-1136 Mosby. St. Louis, MO
^ Austin, J, Ali, T Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management. Paediatr Anaesth 2003;13,3-11
^ McNamara, VM, Crabbe, DC Tracheomalacia. Paediatr Respir Rev 2004;5,147-154
^ Carden, K. A.; Boiselle, P. M.; Waltz, D. A.; Ernst, A (2005). "Tracheomalacia and tracheobronchomalacia in children and adults: An in-depth review". CHEST Journal. 127 (3): 984–1005. doi:10.1378/chest.127.3.984. PMID 15764786.
^ Benjamin, B Tracheomalacia in infants and children. Ann Otol Rhinol Laryngol 1984;93,438-442

References

Carden, KA, Boiselle, PM, Waltz, DA, et al. (2005) Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest 127,984-1005.
Clements, B Congenital malformations of the lungs and airways. Taussig, LM Landau, LI eds. Pediatric respiratory medicine 1999,1106-1136 Mosby. St. Louis, MO
Austin, J, Ali, T Tracheomalacia and Bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management. Paediatr Anaesth 2003;13,3-11
McNamara, VM, Crabbe, DC Tracheomalacia. Paediatr Respir Rev 2004;5,147-154
Benjamin, B Tracheomalacia in infants and children. Ann Otol Rhinol Laryngol 1984;93,438-442

External links

Bronchomalacia Information and Education

UpToDate Contents

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1. 成人における気管軟化症および気管気管支軟化症 tracheomalacia and tracheobronchomalacia in adults
2. 胸腔内気道の先天異常および気管食道瘻 congenital anomalies of the intrathoracic airways and tracheoesophageal fistula
3. 小児における喘息以外の喘鳴疾患 wheezing illnesses other than asthma in children
4. 肺移植後の気道合併症 airway complications after lung transplantation
5. フレキシブル気管支鏡下バルーン拡張術 flexible bronchoscopy balloon dilation

English Journal

Extrinsic bronchial compression due to patent ductus arteriosus closure device.

Fitzmaurice GJ, Coleman DM, Walsh KP, Oslizlok P, Russell JD, McGuinness JG.SourceDepartment of Cardiothoracic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. Electronic address: gfitzmaurice@doctors.org.uk.
The Annals of thoracic surgery.Ann Thorac Surg.2013 Jun;95(6):e143-5. doi: 10.1016/j.athoracsur.2012.11.035.
Interventional cardiology provides a valuable nonoperative approach for the modern management of patent ductus arteriosus (PDA) in patients with non-complex congenital heart disease. We describe a patient with a right-sided aortic arch who developed severe bronchomalacia after PDA device closure tha
PMID 23706465

Late outcomes for the surgical management of absent pulmonary valve syndrome in infants.

Hu R, Zhang H, Xu Z, Liu J, Su Z, Ding W.SourceHeart Center, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Interactive cardiovascular and thoracic surgery.Interact Cardiovasc Thorac Surg.2013 Jun;16(6):792-6. doi: 10.1093/icvts/ivt050. Epub 2013 Feb 24.
OBJECTIVES Absent pulmonary valve syndrome (APVS) is a rare cardiac malformation that is usually associated with aneurysmal dilatation of pulmonary arteries and respiratory distress. The surgical mortality of neonates and infants with APVS has decreased tremendously, from 60% in 1980s to 10-20% rece
PMID 23439440

Japanese Journal

瘢痕性気道狭窄に対するステント治療の限界(<ミニ特集>「気道ステントをめぐる諸問題-pros and cons」)

野守裕明,池田公英,岩谷和法,小林広典,森毅
気管支学 : 日本気管支研究会雑誌 29(1), 7-13, 2007-01-25
目的.瘢痕性気道狭窄に対するステント治療後にステントによる再狭窄を呈した4症例を報告する.症例.症例1は48歳男性.1991年に経験した症例で肺癌に対する気管分岐部形成術後の吻合部軟化症に対してmetallic stentを用い,留置後12ヶ月後にmetallic stentが原因の気道狭窄を生じ死亡した.症例2は56歳女性.結核による瘢痕性気管狭窄例で,Dumon stent挿入後4ヶ月後にステ …
NAID 110006277498

気管支粘液栓で発見された高齢者の特発性気管支軟化症の1例

吉川素子,石田卓,井上恵一,菅原綾,渡邉香奈,金澤賢也,斎藤純平,大塚義紀,橋本直人,棟方充
気管支学 : 日本気管支研究会雑誌 27(6), 452-456, 2005-09-25
背景.CTの描出技術の進歩により非侵襲的な気道の評価が可能となってきた.症例.78歳, 女性.自覚症状はなく胸部異常陰影精査にて当科紹介.胸部CTで左肺門部から胸膜に続く数珠状の陰影を認め, 気管支粘液栓が疑われた.気管支鏡検査にて気管は正常であったが, 呼気時に両側の主気管支から末梢区域気管支の50%以上の全周性の虚脱を認めた.左B^3bは黄色物質で閉塞されており, 生検組織はフィブリン塊であっ …
NAID 110002975019

Related Pictures

★リンクテーブル★

リンク元	「気管支軟化症」
拡張検索	「tracheo-bronchomalacia」

「気管支軟化症」

Bronchomalacia
Classification and external resources
Specialty	medical genetics
ICD-10	Q32.2
ICD-9-CM	748.3
	[edit on Wikidata]

　　[★]

英: bronchomalacia
関: 気管軟化症

「tracheo-bronchomalacia」

　　[★] 気管・気管支軟化症

[1] Carden, KA, Boiselle, PM, Waltz, DA, et al. (2005) Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest 127,984-1005.

[2] Clements, B Congenital malformations of the lungs and airways. Taussig, LM Landau, LI eds. Pediatric respiratory medicine 1999,1106-1136 Mosby. St. Louis, MO

[3] Austin, J, Ali, T Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management. Paediatr Anaesth 2003;13,3-11

[4] McNamara, VM, Crabbe, DC Tracheomalacia. Paediatr Respir Rev 2004;5,147-154

[5] Carden, K. A.; Boiselle, P. M.; Waltz, D. A.; Ernst, A (2005). "Tracheomalacia and tracheobronchomalacia in children and adults: An in-depth review". CHEST Journal. 127 (3): 984–1005. doi:10.1378/chest.127.3.984. PMID 15764786.

[6] Benjamin, B Tracheomalacia in infants and children. Ann Otol Rhinol Laryngol 1984;93,438-442

v t e Congenital malformations and deformations of respiratory system (Q30-Q34, 748)

Nose	Choanal atresia

Larynx	Laryngocele - Laryngomalacia

Trachea and bronchus	Tracheomalacia - Bronchomalacia

Lung	Bronchiectasis - Pulmonary sequestration - Congenital cystic adenomatoid malformation

see also non-congenital (J, 460-519)

匿名

検索

案内

案内

bronchomalacia