Abstract
Tracheomalacia and tracheobronchomalacia (TBM) are disorders that occur in both child- and adulthood. They always mean collapse of the trachea or main bronchi characterized by reduction of the lumen by more than 50 percent.
This results in dynamic airway obstruction. TBM is caused by diffuse or segmental weakness of the bronchial wall due to pathological processes.
However, the condition may also be congenital. The diagnosis Is mainly by bronchoscopic examination allowing real-time confirmation of dynamic airway obstruction with respiratory maneuvers as well as determination of the extent and severity of the condition.
Another modality used to diagnose TBM is dynamic computed tomography. Lung function tests are of limited value in the diagnosis of TBM.
At the present time, there is no uniform standardized approach to the treatment of TBM. Specific pharmacological therapy is mainly justified in cases of relapsing polychondritis.
It is necessary to properly treat comorbidities and diseases worsening the severity of malacia, in particular gastroesophageal reflux. Continuous positive airway pressure may also be used.
This may be perceived as a bridge therapy prior to mini-invasive methods. At present, interventional bronchology using tracheal stents and surgery are of increasing importance.
Presented are two cases of surgical repair using posterior membrane tracheobronchoplasty with prolene mesh. In selected patients, the surgical approach seems to be an efficient method that alleviates the symptoms and improves the functional status and quality of life.