Testing & Diagnosis for Tracheomalacia in Children

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Contact the Esophageal Airway Treatment Center

  • 1-617-355-3038

Diagnosing Tracheomalacia at Boston Children’s Hospital

The first step in treating your child is forming an accurate and complete diagnosis. Sometimes a child is incorrectly diagnosed with severe asthma when he really has tracheomalacia. This is one reason why it’s very important that your child’s doctor has lots of experience diagnosing and treating this condition.

There are multiple ways to diagnose tracheomalacia, but the best is a procedure called a dynamic bronchoscopy. During a dynamic bronchoscopy, your child’s doctor will use a thin instrument called a bronchoscope to look in your child’s airway to see whether his trachea is collapsing when he breathes out (or in).

Other ways of diagnosing tracheomalacia include:

  • Dynamic airway CAT (CT) scan: This is a very special, non-invasive procedure that uses X-ray equipment and powerful computers to create detailed, cross-sectional images of your child's body
  • Airway fluoroscopy: A type of X-ray that allows the doctor to have a more detailed look at your child’s trachea

After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Then we meet with you and your family to discuss the results and outline the best treatment options.

Learn more about esophageal disorder testing.

What Causes Tracheomalacia?

A healthy trachea is supported by a series of “c-shaped” rings made of cartilage that help your child’s airway to stay open during exhalation. The most common form of tracheomalacia occurs when the cartilages are wide based and shaped more like a letter “D,” causing the membrane at the back of the airway (the straight line of the D) to interfere with breathing and restrict airflow.

It is often incorrectly assumed that the condition results when the cartilage that goes around the trachea isn’t strong enough to fully support it.  While this theory has long been taught, newer research and our extensive experience at Boston Children’s prove this to be an uncommon cause.

Other types of tracheomalaica occur in the lower trachea or bronchi (the branching airways) or are caused by a cyst (mass) in the chest or in the airway itself.  

Almost all babies with esophageal atresia have some degree of tracheomalacia. Sometimes, however, tracheomalacia can occur on its own, without another condition.

Tracheomalacia may be congenital (present at birth), or acquired later.

Acquired tracheomalacia, also known as secondary tracheomalacia, can be caused by:

  • Related conditions, particularly esophageal atresia
  • A previous treatment for esophageal atresia or another medical condition
  • Heart anomalies, such as vascular rings (Boston Children’s was the first hospital to treat vascular rings surgically, and the procedure is now offered using highly precise minimally invasive robotic surgery)
  • Other internal structures or masses pushing on the trachea, causing it to narrow
  • Recurrent infection
  • Tracheostomy tubes

Make an Appointment

To make an appointment or speak with a member of our team, please call 617-355-3038.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at +01-617-355-5209.

Boston Children’s is so much more than a hospital—it’s a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible. ”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000
For Referring Providers: 844-BCH-PEDS | 844-224-7337