Conditions + Treatments

Advanced Treatments for Tracheomalacia in Children

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Contact the Esophageal Airway Treatment Center

  • 1-617-355-3038

Tracheomalacia may slowly diminish in severity over time, but it may not go away on its own.  Your infant should be monitored closely by his care team and may benefit from humidified air, chest physical therapy and perhaps a continuous positive airway pressure (CPAP) device.

However, some children do not outgrow more severe forms of tracheomalacia. Instead, they adapt to it and in many ways learn to live with the discomfort and complications. Our doctors don’t want your child to have to adapt to discomfort or dysfunction.  That’s why Boston Children’s offers advanced surgical options that can provide your child with complete relief.

If your child is having blue spells or dying spells, problems eating, episodes of choking, problems with noisy breathing or coughing or exercise intolerance, surgery may be necessary. The treatments depend on the type and locations of the tracheomalacia, and each treatment is customized for the individual child. Some of the procedures were developed here and are not yet available elsewhere.

Surgical options include:

  • Aortopexy: A safe and reliable procedure from the 1950s that provides immediate and permanent relief of some types of severe tracheomalacia. This surgery opens up the trachea by moving up the aorta (the body’s main blood vessel) and attaching it to the back of the breastbone (sternum).
  • Tracheopexy: Similar to an aortopexy, this procedure opens up and supports the airway by suspending the front of the tracheal wall from the back of the sternum.  Sometimes the thymus gland is removed to create more space between the aorta and the sternum. In addition to tracheopexy, we sometimes perform:
  • Bronchopexy: For airway collapse that involves the bronchial airways, supporting them may improve airflow
  • Posterior aortopexy: In some situations, the aorta on the spine compresses the back of the airway. In these children, moving the aorta back can take the pressure off the airway and improve airflow.
  • Posterior tracheopexy: An operation developed at Boston Children’s Hospital. Our surgeons can support the flexible back wall of the trachea against the spine. It is much more effective than the other options alone and can be used in combination with the other procedures.
  • Tracheal diverticulum resection: Usually after EA with TEF repair, a pouch or diverticulum remains that can trap secretions and collapse the airway. Our surgeons have developed techniques to completely resect (cut out) these lesions to make the airway nearly normal.
  • Combined procedures: Our surgeons very often discover more than one problem with the airway and/or esophagus. Using a variety of techniques, they will correct all the problems in one combined procedure. This procedure may include:
    • Anterior/posterior tracheopexies
    • Slide tracheoplasty: A technique to make the airway larger
    • Rotational esophagealplasty: A technique to rotate the esophagus away from the trachea so that there is no chance for recurrence of a TEF
  • Placing a stent: Your child’s doctor may also choose to place a stent in your child's trachea, temporarily. A stent is a narrow tube that holds the trachea open and encourages the tissues to grow around it. Stents are generally avoided in favor of other surgical options, however our doctors have the most experience with esophageal stents in the country.

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.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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