Traheomalacia

Traheomalacia

    * Introduction
    * Symptoms and Diagnosis
    * Treatment
Traheomalacia is a condition characterized by support flaciditatea tracheal cartilage, leading to tracheal collapse especially necessary when an intense flow of air. Normal trahea expands slightly during inspiration and expiration colabeaza easily. These processes are exaggerated in traheomalacie, leading to airway collapse on expiration. Traheomalacie symptoms are frequent or ciriitul expiratory laryngeal stridorul. If the condition extends to bronsii traheobronhomalacie it is called. The same condition affects the larynx naming laryngomalacia.
If symptoms are severe enough to need treatment. This ranges from medical control on mechanical ventilation until tracheal stent placement and surgery. Surgical techniques include aortopexia, traheopexia, traheobronhopexia and tracheostomy. None of these techniques have not proved superior to each other. Deficiency of cartilage may be present in approximately 70% of patients with tracheoesophageal fistula. Traheomalacia is rarely found in combination with laryngomalacia.
The whole structure of cartilage is diffusely involved in congenital anomalies or just a localized area of rigidity can be observed secondary to abnormal development of the intestine and vasculaturii embryonic life. A vascular ring around trachea prevents normal development in this area of the trachea and traheomalacia incarceration is seen in the area.
Gained traheomalacie Cauzurile of high-frequency occur in children and adults. These lesions usually cause focal traheomalacie and may be the result of traheostomii and endobronchial tube placement, chest trauma, chronic inflammation traheobronsitei. May be secondary to pulmonary resection and tracheal neoplasms.
Surgical therapy is indicated when conservative measures failed. The indication for tracheostomy is represented by severe symptoms, failure of medical therapy and traheomalacie proximal or diffuse. Indication of aortopexie are reflex apnea, recurrent pneumonia, intermittent respiratory obstruction and failure to intubate a patient extuba.
Pathogenesis Anatomy and physiology of the trachea: The trachea begins at cricoidian cartilage and ends at T5 thoracic vertebrae. It lengthens and expands during inspiration and expiration in colabeaza and shortens. 15-20 incomplete rings of cartilage prevent its collapse. The trachea is separated from the esophagus posterior spine. Jugular venous arch in the chest is above the sternum.
Pathophysiology traheomalaciei: Traheomalacia affects mostly the distal third of the trachea. By its intrinsic flexibility or compliance, trachea changes its size during the respiratory cycle. Tracheal dilation and elongation occur during inspiration, and shortness of collapse occurring during expiration. The emphasis of this cycle can cause excessive collapse of the tracheal lumen, distorting the entire length or a segment of the trachea located. It is rarely found because of laryngomalacia with different developmental pathways of the trachea and larynx.
Generally colapsibilitatea shows abnormal structural stiffness loss, such as softening trachea. Any pathological process that affects the integrity of the tracheal wall is apt to cause changes in tracheal compliance. Anatomic defect may be minor and escape detection. Functional interference with ventilation can cause the flow of respiratory secretions and interfere with cleaning. Functional impairment is proportional to the length of segment affected and the degree of stenosis. In diffuse tracheal disease or adhesion uneven rebound peritraheale extensive trachea during inspiration and expiration colabeaza to interfere with tracheal function. Causes and Risk Factors Traheomalacia is a structural abnormality of the tracheal cartilage allowing collapse of its walls and airflow obstruction. There is a deficiency or abnormality of cartilage support. Tracheo cartilage immaturity is considered to be the cause of type I disease, while previously healthy cartilage degeneration is enough to produce other types of disease. Inflammatory processes, extrinsic compression by vascular anomalies or neoplasms may produce degeneration. The disease may be associated with a variety of congenital anomalies, including cardiovascular defects, delayed development, abnormal esophageal and gastroesophageal reflux. Traheomalacia may be caused by a diffuse process of congenital origin or through a congenital abnormality located as a vascular ring, unnamed arteries abnormal esophageal atresia and tracheoesophageal fistula. Internal compression endobronchial or tracheostomy tube may also be due.
Traheomalaciei Classification: - Traheomalacie primary (congenital) in policondrita syndrome, Mounier - Secondary traheomalacie (won) in emphysema, trauma, chronic bronchitis, chronic inflaamtie, chronic external compression of the trachea, vascular rings.