In tracheobronchomalacia, airway collapse alters the mucociliary clearance mechanism, leading to retained secretions and recurrent respiratory infections. First-line management centres on maximising medical therapy to optimise airway clearance and establish adequate nutritional status — essential prerequisites before any surgical option is considered.

Treatment Goals

The protocol targets controlled airway secretions and respiratory infections, together with optimum nutrition — with at least two weeks of adequate growth and positive nitrogen balance as markers of medical optimisation.

Treatment Approach

Maximum medical therapy is directed at optimising mucociliary clearance, addressing the underlying mechanism by which airway collapse impairs secretion transport.

The complete structured regimen — all components, sequencing, and clinical guidance — is in the full protocol below.

References

DOI: 10.1016/j.sempedsurg.2021.151062

In our opinion, all patients need to be optimized using medical therapy prior to considering surgical correction if that is an option, at a minimum to control secretions and infections, as well as optimum nutrition and at least two weeks of adequate growth and positive nitrogen balance in order to tolerate the stress of surgery.
At the EAT Center, the mainstay of medical management is the optimization of mucociliary clearance since the airway clearance mechanism is altered by airway collapse.

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Treatment of Tracheobronchomalacia: First-Line Medical Management

Treatment Goals

Treatment Approach

References