Bronchomalacia

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Classification according to ICD-10
Q32.2 Congenital bronchomalacia
J39.8 Other specified diseases of the upper respiratory tract
ICD-10 online (WHO version 2019)

The bronchomalacia is a disease caused by an instability of the Bronchialsystemes is characterized. This is due to the abnormal softness of the cartilage , which is supposed to keep the bronchi open, so that there is at least 50% narrowing of the lumen at the time of the exhalation phase .

Bronchomalacia often occurs together with tracheomalacia and is then also referred to as tracheobronchomalacia .

Classification

Depending on the cause, a distinction can be made:

  • Primary form, congenital weakness of the cartilage rings
  • Secondary form, acquired, weakening of the cartilage rings due to external compression, after prolonged intubation, a vascular ring or a mass, usually bronchogenic cyst

There is an association with esophageal atresia , tracheoesophageal fistula , VACTERL association , congenital heart defects, and other syndromes .

Clinical manifestations

The main symptom is a persistent, inexplicable stridor , often in newborns and infants, usually in the first years of life.

Diagnosis

The diagnosis can be made endoscopically by bronchoscopy or by virtual bronchoscopy (using 3-D computed tomography ).

therapy

Adapted forms of ventilation and possibly custom-made implants are usually considered for treatment.

literature

  • R. Boogaard, SH Huijsmans, MW Pijnenburg, HA Tiddens, JC de Jongste, PJ Merkus: Tracheomalacia and bronchomalacia in children: incidence and patient characteristics. In: Chest. Vol. 128, No. 5, November 2005, pp. 3391-3397, doi: 10.1378 / chest.128.5.3391 , PMID 16304290 .
  • JD Finder: Primary bronchomalacia in infants and children. In: The Journal of pediatrics. Volume 130, Number 1, January 1997, pp. 59-66, PMID 9003852 .
  • JC Denneny: Bronchomalacia in the neonate. In: The Annals of Otology, Rhinology, and Laryngology. Vol. 94, No. 5 Pt 1, 1985 Sep-Oct, pp. 466-469, doi: 10.1177 / 000348948509400510 , PMID 3901858 .

Individual evidence

  1. ^ E. Yalçin, D. Doğru, U. Ozçelik, N. Kiper, AT Aslan, A. Gözaçan: Tracheomalacia and bronchomalacia in 34 children: clinical and radiologic profiles and associations with other diseases. In: Clinical pediatrics. Vol. 44, No. 9, 2005 Nov-Dec, pp. 777-781, doi: 10.1177 / 000992280504400905 , PMID 16327964 .
  2. ↑ a b Deutsches_Ärzteblatt
  3. ↑ AM Ho, A. Winthrop, EF Jones, MP Flavin: Severe Pediatric Bronchomalacia. In: Anesthesiology. Vol. 124, No. 6, June 2016, p. 1395, doi: 10.1097 / ALN.0000000000000989 , PMID 26682632 .
  4. ↑ M. Xiong, W. Zhang, D. Wang, J. Xu: CT virtual bronchoscopy: imaging method and clinical application. In: Chinese medical journal. Vol. 113, No. 11, November 2000, pp. 1022-1025, PMID 11776117 .
  5. ↑ WE Higgins, K. Ramaswamy, RD Swift, G. McLennan, EA Hoffman: Virtual bronchoscopy for three-dimensional pulmonary image assessment: state of the art and future needs .. In: RadioGraphics. Vol. 18, 1998, p. 761, doi: 10.1148 / radiographics.18.3.9599397 .
  6. ^ W. De Wever, J. Bogaert, JA Verschakelen: Virtual bronchoscopy: accuracy and usefulness – an overview. In: Seminars in ultrasound, CT, and MR. Vol. 26, No. 5, October 2005, pp. 364-373, PMID 16274005 (review).
  7. ↑ J. Austin, T. Ali: Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anesthesia management. In: Pediatric anesthesia. Vol. 13, No. 1, January 2003, pp. 3-11, PMID 12535032 (review).
  8. ↑ K. Aaseboe, AK Berstad, BT Skadberg: Noninvasive treatment of bronchomalacia, successful ventilation of a severely ill infant. In: Acta paediatrica. Vol. 96, No. 2, February 2007, pp. 310-312, PMID 17429927 .