TRACHEOBRONCHOMALACIA IN CHILDREN

Tracheobronchomalacia (TBM) is an important cause of airway distress d uring infancy, but it generally resolves as the airway enlarges. To as sess the origin and natural history of TBM, a chart review and telepho ne survey were conducted for 50 patients with TBM at the Children's Ho spital of Philadelphia (Pa). This study revealed that TBM is a relativ ely common airway abnormality and is found on 15% of all diagnostic br onchoscopies. Prematurity, low birth weight, bronchopulmonary dysplasi a, and prolonged ventilation predispose patients to the most severe sy mptoms. In our study, a tracheotomy with continuous positive airway pr essure was required by 75% of the premature infants and 25% of the ful l-term infants with TBM. Seventy-one percent of all patients underwent decannulation without any other surgical intervention and remained ne arly asymptomatic. Some patients could not undergo decannulation becau se of other airway lesions. In most instances, TBM is a self-limited d isease that resolves without surgery.