What is Bronchomalacia

Bronchomalacia is a condition characterized by excessive weakness or "floppiness" of the bronchial walls, which causes the airways to collapse during expiration and obstruct airflow. While it can be a primary condition, it is often secondary to other respiratory issues or external compression, and it primarily affects the lower airway system.

What causes Bronchomalacia?

The primary mechanism behind Bronchomalacia is the abnormal softening of the cartilage that supports the bronchial tubes. In healthy lungs, these cartilaginous rings maintain airway patency; however, in individuals with Bronchomalacia, the cartilage is either underdeveloped, damaged, or undergoes atrophy. This structural instability leads to the narrowing of the airways during the act of breathing out, which can cause symptoms like wheezing, chronic cough, or difficulty clearing secretions.

Who is typically affected by Bronchomalacia?

Bronchomalacia is most commonly diagnosed in infants and young children, often as a result of congenital developmental issues. However, it can also manifest in adults due to long-term chronic obstructive pulmonary disease (COPD), prolonged mechanical ventilation, or trauma. While the exact global prevalence is difficult to determine because many mild cases remain undiagnosed, it is frequently associated with other airway conditions. At DiseaseMaps.org, we have observed that patients often report a long diagnostic journey before identifying Bronchomalacia as the root cause of their persistent respiratory distress.

How is Bronchomalacia classified?

Clinicians generally categorize Bronchomalacia based on the underlying cause and the extent of the airway involvement:

• Primary Bronchomalacia: A congenital condition involving intrinsic weakness of the bronchial cartilage.


• Secondary Bronchomalacia: Caused by external factors such as vascular rings, mediastinal masses, or chronic inflammation.


• Localized vs. Diffuse: Refers to whether the softening is limited to a single bronchus or affects multiple segments of the bronchial tree.

How is this different from Tracheomalacia?

While both conditions involve airway softening, they occur in different locations. Tracheomalacia affects the trachea (the windpipe), whereas Bronchomalacia specifically impacts the smaller bronchial tubes leading into the lungs. Often, these two conditions can coexist, a state sometimes referred to as tracheobronchomalacia.

Next steps

• Consult a pediatric or adult pulmonologist for a bronchoscopy, which is the gold-standard diagnostic tool.


• Keep a symptom log to track triggers, such as respiratory infections or physical exertion.


• Connect with the DiseaseMaps.org community to share experiences with others managing this condition.

Medical disclaimer: This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment.

References

• NIH Genetic and Rare Diseases Information Center (GARD)


• Orphanet: The portal for rare diseases and orphan drugs


• PubMed: Clinical reviews on airway malacia and bronchoscopic evaluation


• American Thoracic Society (ATS) guidelines on pediatric airway disorders