Which are the causes of Tracheobronchomalacia?

Tracheobronchomalacia is a condition characterized by the weakening or collapse of the trachea (windpipe) and bronchi (airways leading to the lungs). This can lead to various respiratory symptoms and complications. While the exact cause of tracheobronchomalacia is not always clear, there are several factors that can contribute to its development.

1. Congenital Factors: Tracheobronchomalacia can be present at birth or develop during infancy due to congenital abnormalities. These abnormalities may include weak cartilage in the trachea and bronchi, incomplete development of the airway structures, or genetic disorders affecting the connective tissues.

2. Acquired Factors: Tracheobronchomalacia can also develop later in life as a result of acquired conditions or external factors. Some of these factors include:

• Chronic Inflammation: Prolonged inflammation of the airways, such as from chronic bronchitis or recurrent respiratory infections, can weaken the trachea and bronchi, making them more susceptible to collapse.


• Chronic Obstructive Pulmonary Disease (COPD): Conditions like emphysema and chronic bronchitis, which fall under the umbrella of COPD, can cause structural changes in the airways, leading to tracheobronchomalacia.


• Tracheostomy: Individuals who have undergone a tracheostomy, a surgical procedure to create an opening in the trachea, may develop tracheobronchomalacia as a complication. The presence of a tracheostomy tube can weaken the tracheal cartilage over time.


• External Compression: Any condition or external factor that puts pressure on the trachea and bronchi can contribute to their weakening. This includes tumors, enlarged lymph nodes, or vascular abnormalities in the chest.


• Connective Tissue Disorders: Certain connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome, can affect the strength and elasticity of the tracheal and bronchial tissues, increasing the risk of tracheobronchomalacia.


• Age: Advanced age can be a contributing factor, as the cartilage in the airways may naturally weaken over time.

3. Trauma: In some cases, tracheobronchomalacia can be caused by trauma to the chest or neck. This can occur due to a severe injury, prolonged intubation, or damage during surgery.

4. Idiopathic: In certain instances, the exact cause of tracheobronchomalacia remains unknown. This is referred to as idiopathic tracheobronchomalacia.

It is important to note that tracheobronchomalacia can vary in severity, ranging from mild to severe. The symptoms experienced by individuals with tracheobronchomalacia can also differ, depending on the degree of airway collapse. Diagnosis and treatment of tracheobronchomalacia typically involve a multidisciplinary approach, including pulmonologists, otolaryngologists, and thoracic surgeons.