Lower airway malacia in children: retrospective study in a tertiary paediatric hospital

Airway malacia is a condition of excessive airway collapsibility during expiration. As it may lead to life threatening events and even death in children, it is important to recognise and treat this disorder. In this study, we aimed to evaluate clinical features, prognoses, and associated disorders of the patients with lower airway malacia. In a total of 390 patients and 410 bronchoscopies, lower airway malacia was diagnosed in 65 (16.6%) children between 2014 and 2020. Demographic and clinical features, video image records of bronchoscopy and prognoses of the patients were evaluated retrospectively. The median age was 1 year and 2 months. Thirty-five (53.8%) of the patient 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 localizations of airway malacias are shown in Table 1. The distinction of cause of admission and physical examination findings according to the type of malacia is shown in Table 2. Fifty-eight (89.2%) patients had other co-morbidities associated with airway malacia (Table 3). Inhaled ipratropium bromide therapy was started for 37 (56.9%) patients and terminated in four patients because of clinical improvement yet the others continued to treatment. Ten (15.4%) patients required continuous positive pressure support. Three patients (4.6%) died during follow-up. Lower airway malacia is an important disorder in children with respiratory problems and flexible bronchoscopy is a valuable diagnostic method. In patients with atypical respiratory findings and no response to treatment, lower airway malacia should be kept in mind.