Bronchomalacia

What is bronchomalacia?

Bronchomalacia is a condition where the cartilage in the bronchi is weak. Your bronchi are flexible but firm airways in your lungs. Normally, c-shaped cartilage structures surround your bronchi like protective shells. These firm structures allow your bronchi to open as your lungs expand and contract. Without their support, your bronchi become narrow, especially during exhalation (when you breathe out).

How common is bronchomalacia?

Bronchomalacia usually affects newborns, especially those who were born prematurely (early) and those with Down syndrome. In rare cases, it affects older children and adults.

How does bronchomalacia affect my baby?

Bronchomalacia can block or narrow the bronchi. When the bronchi are blocked or too narrow, your baby may have breathing problems and difficulty getting enough oxygen. In very severe cases, the condition can be life-threatening.

What is tracheobronchomalacia (TBM)?

In many cases, people with bronchomalacia also have tracheomalacia, which is a weakness in the tracheal walls. These two conditions together are called tracheobronchomalacia (TBM).

Like bronchomalacia, tracheomalacia can interfere with breathing and is more common in newborns. Tracheomalacia is often linked to a rare birth defect known as esophageal atresia.

What causes bronchomalacia?

Bronchomalacia in newborns, known as primary bronchomalacia, is usually a result of:

• Congenital heart disease.
• Underdeveloped lung cartilage due to being born early.
• Williams-Campbell syndrome: Congenital (inherited) condition that causes weakened cartilage in the bronchi.

Bronchomalacia that isn’t present at birth is known as secondary bronchomalacia, and causes include:

• Chest injury.
• Chronic bronchitis.
• Emphysema.
• Long-term ventilator therapy.
• Tuberculosis (TB).
• Tumors or benign (noncancerous) growths in the lungs.

What are the symptoms of bronchomalacia?

If you or your child has bronchomalacia, you may notice:

• Barking cough without phlegm.
• Cyanosis (blue-tinted skin).
• Fatigue.
• Frequent infections like colds and respiratory illnesses.
• Shortness of breath (dyspnea).
• Stridor (noisy, vibrating sound when breathing).
• Wheezing.

Is bronchomalacia contagious?

You cannot catch bronchomalacia from someone else or spread it to others. Bronchomalacia is not caused by upper respiratory infections, influenza (flu) or other contagious illnesses.

How is bronchomalacia diagnosed?

Your provider will perform a physical examination and listen to your or your child’s lungs. If appropriate, they’ll order additional testing or place additional referrals.

What tests diagnose bronchomalacia?

Imaging tests allow your provider to see inside the lungs. You or your baby may need:

• Bronchoscopy.
• CT scan.
• MRI.
• X-ray.

How is bronchomalacia treated?

Newborns with mild bronchomalacia may only need regular check-ins with their healthcare provider. The condition often resolves on its own by 6 months of age as their lungs mature.

If bronchomalacia is interfering with your baby’s oxygen levels, providers may recommend a continuous positive airway pressure (CPAP) device. A CPAP device is a mask that goes over your baby’s nose and mouth and connects to a machine. The machine delivers gentle, continuous air pressure to the mask. The air pressure can help keep the bronchi open. Your baby may need this device for a few weeks or until their lungs have fully developed.

In very severe cases of bronchomalacia and respiratory failure, your baby may need a ventilator to keep their bronchi open and help them breathe.

Bronchomalacia treatment in adults depends on the cause. If you have emphysema or chronic bronchitis, you may need medications and regular checkups to help manage your symptoms. A CPAP device may also be helpful, especially when sleeping. In severe cases, patients may need ventilator support in a hospital.

How can I prevent bronchomalacia?

There’s no known way to prevent bronchomalacia in newborns. It is not a result of something you did during pregnancy. If you’re pregnant, learn the signs of premature labor so you can seek medical care right away. Prompt care may prevent your baby from being born too early.

Because bronchomalacia in adults is often a result of lung disease, good lung care may help prevent it. Adults can take these steps to keep their lungs as healthy as possible:

• Don’t smoke or vape. Smoking and vaping raise the risk of chronic bronchitis, emphysema and lung cancer. If you do smoke and need help quitting, talk to your provider.
• Get your home tested for radon. You can’t see or smell radon gas in your home, but it can cause lung cancer.
• Wear personal protective equipment (PPE). A respirator should be worn when you’re working with chemicals or particles like gases, vapors, fumes, dust and soot.

Is bronchomalacia curable?

Many babies with bronchomalacia recover and thrive once their lung cartilage has matured and hardened. If the condition is caused by a blockage like a tumor, removing the blockage usually cures bronchomalacia.

In adults with emphysema or chronic bronchitis, bronchomalacia usually requires ongoing care and can’t be cured. However, your healthcare provider can help you manage symptoms and feel better.

When should I see my healthcare provider?

See your provider regularly for well checkups and to discuss any changes to your health. Seek emergency care if you or your child has:

• Bluish lips or skin.
• Chest retractions (pulling inward with breathing).
• Fainting or inability to wake.
• Shortness of breath or trouble breathing.
• Wheezing or stridor.

A note from Cleveland Clinic

Bronchomalacia is a breathing problem that usually affects newborns, especially preemies with underdeveloped lungs. With successful treatment, most babies recover and thrive. In adults, healthcare providers treat the underlying cause. They’ll give you medications for emphysema or chronic bronchitis. Always discuss any breathing problems with your provider and attend regular checkups.