Pediatric Airway Conditions 

Tracheomalacia is a softening of the trachea  or "windpipe". This softening may cause the trachea to collapse, which may prevent normal activities such as eating, crying, running, and overall breathing. In addition, a collapsing trachea may make it harder for the patient to clear secretions, fight respiratory infections and overall thrive in growth and development.  

The cause of tracheamalacia in pediatric patients can either be congenital (the patient is born with it) or developed later in life. Congenital tracheamalacia is often associated with other conditions such as esophageal atresia and/or tracheoesphogeal fistula.

 

Symptoms of tracheomalacia may include: noisy breathing (specifically when exhaling), frequent respiratory infections, inability to clear secretions, low oxygen levels, and failure to thrive.

 

Parents and caregivers who suspect their child may be suffering from tracheamalacia should consult their health care provider for further evaluation. In addition to a clinical exam/health history, tests such as swallow studies, bronchoscopy, and laryngoscopy, can be performed to assist in the diagnosis of tracheamalacia. 

Treatment for tracheamalacia will vary depending on symptoms, severity of the condition, and other medical conditions. Treatment may include therapy, medications, and/or surgery. Surgical options may include: 

Tracheopexy - This procedure opens up and supports the airway by suspending the back of the tracheal wall from the back of the sternum.         

suffered with difficulty breathing, "blue episodes" choking, and frequent hospitalizations.

Aortopexy - A safe and reliable procedure that provides immediate and permanent relief  of severe tracheomalacia. This surgery opens up the trachea by moving up the aorta (the body's main blood vessel) and attaching it to the back of the breastbone (sternum).

Boston Children's Hospital

Boston Children's Hospital's (BCH) Esophageal and Airway Treatment Center is the leading hospital for treating airway problems in pediatric patients. Because children with airway issues often have other conditions, you are provided with a team to evaluate your child. This team may include: surgical team, gastroenterologists, pulmonologists nutritionists, feeding specialists, physicians assistants, nursing staff and social workers. 

For more information or to schedule an appointment, contact the Esophageal and Airway Treatment Center at (617) 355- 3038, or visit their website by clicking HERE.

                   

BCH Team

Leah Frain, FNP

Dori Gallagher, RN

EAT Program Director

Thomas Hamiliton, MD
Assistant Program Director, EAT  

Russell Jennings, MD
Director, EAT Program

 Surgical Director

CV

Michael Manfredi MD
Co-Director EAT Program

Gastroentrologist

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Frequently Asked Questions
Caregiver Profile: Russell Jennings, MD
Boston Children's Hospital
Esophageal & Airway Treatment Center 
Boston Children's Hospital
Caregiver Profile: Michael Manfredi, MD
Boston Children's Hospital
How We Treat Tracheomalacia
Boston Children's Hospital
Caregiver Profile: Dori Gallagher, RN
Boston Children's Hospital
Care of Esophageal Atresia
Boston Children's Hospital

Why Boston Children’s Hospital?

My child's physician/surgeon feels my child will "outgrow" their condition. Do I really need a second opinion? add a new question?


If you are searching the Internet for additional options, chances are you are not comfortable with your child's condition. Seeking a second opinion never hurts. It will either confirm what your physician/surgeon has told you, or it will open up additional treatment options to consider. question go to app settings and press "Manage Questions" button.




How do I schedule an appointment with Boston Children's Hospital?


To schedule an appointment, call the Esophageal and Airway Treatment Center at 617-355-3038.




What is Boston Children's Hospital like?


Boston Children’s Hospital is located in the heart of Boston, Massachusetts and is top rated. The hospital only treats children, and is geared towards families. Inside the hospital, you will find games, activities, and playrooms for children. The hospital uses bright colors and symbols to guide patients to the office or floor they need to visit. A large food court is located on the first floor and includes several dining options. Several resources are available for families who may need assistance and international families. For more information, visit http://www.childrenshospital.org/patient-resources/family-resources




What will our first appointment be like?


Your first set of appointments will be tailored to your child's medical history, symptoms and concerns. The Esophageal and Airway Treatment Center will try to coordinate all necessary appointments into a 2-3 day window, to accomodate families coming from out of town.

It is important to bring the following to your appointments:
1) Insurance information

2) List of medications and medical procedures

3) List of questions you have

4) A second person (if you can!) This will allow one person to care for the child and one to

more actively talk and listen.




What is a Tracheopexy?


Tracheopexy is a surgical procedure that opens up and supports the airway by suspending the back of the tracheal wall from the back of the sternum. An incision is made in the patient’s back near the armpit. The procedure will last between 6-8 hours. Once out of surgery the patient will be transferred to the Intensive Care Unit, or ICU for monitoring. Once the patient is ready (usually 1-2 days post op), the patient will be moved to the surgical floor for the rest of their stay (2-10 days). Once discharged, the patient can return to activity as they feel comfortable. There is no immediate follow up, unless complications or questions arise.




What is an Aortopexy?


Aortopexy is a surgical procedure that provides immediate and permanent relief of severe tracheomalacia by opening up the trachea by moving up the aorta (the body's main blood vessel) and attaching it to the back of the breastbone (sternum). An incision is made in the patient’s chest, usually, horizontally. The procedure will last between 6-8 hours. Once out of surgery the patient will be transferred to the Intensive Care Unit, or ICU for monitoring. Once the patient is ready (usually 1-2 days post op), the patient will be moved to the surgical floor for the rest of their stay (2-10 days). Once discharged, the patient can return to activity as they feel comfortable. There is no immediate follow up, unless complications or questions arise.




Can I stay with my child?


This is a very common and important question. The answer is yes!

Pre-op – You may stay with your child until they are taken into surgery. Some children go freely with the medical staff, while others may be apprehensive. If appropriate, you may “gown up” and walk/carry your child into the operating room. Once they are somewhat sedated, you will then leave.

Post-op – Your child is monitored in post op until they are ready to be transferred to the Intensive Care Unit (ICU). Generally, this will take between 1-2 hours, depending on the patient and bed availability in the ICU. Once transferred to the ICU, you will be notified and be taken to the ICU waiting room. Once your child is accessed and checked in with the ICU staff, you will be brought to their room. Again, this can take some time, depending on the child and the needs of the ICU.

Intensive Care Unit – You may stay with your child in the ICU, including overnight.

Surgical Floor – You may stay with your child once they are transferred to the surgical floor. Beds and pull out furniture are available. Your child may have their own room with bathroom, or may share a room and bathroom, depending on the needs of the hospital.




What is recovery like? When can my child resume normal activities?


Recovery will depend on the prexisting health and medical condition of the child. Most children will recover 4-14 days after tracheopexy and/or aortopexy. Each child will respond differently. Patients can resume activity when they feel ready, It is important to keep the surgical site clean, and dry. It is important to look for signs of post operative infection such as increased pain, swelling, fever, redness and drainage from the site. If you have any questions, contact the patient's surgical team.





[Boston Children's Hospital]. (2017, Apr 7). Caregiver Profile: Russell Jennings, MD [Video File]. Retrieved from https://www.youtube.com/watch?v=VG4SX554KvE

[Boston Children's Hospital]. (2017, May 9). Caregiver Profile: Michael Manfredi, MD  [Video File]. Retrieved from https://www.youtube.com/watch?v=3Fz5xXUj0-Y

[Boston Children's Hospital]. (2017, May 9). Caregiver Profile: Dori Gallagher, RN [Video File]. Retrieved from https://www.youtube.com/watch?v=wqnOEfXSVtc

[Boston Children's Hospital]. (2018). Care of Esophagel Atreisa: Fact or Fiction [Video File]. Retrieved from https://www.facebook.com/BostonChildrensHospital/videos/10159942211555333/

[Boston Children's Hospital]. (2017, Jan 30). Esophageal and Airway Treatment Center (EAT) [Video File]. Retrieved from https://www.youtube.com/watch?v=3NnW0qqsb2I

[Boston Children's Hospital]. (2017, Jun 16). How we treat Tracheomalacia [Video File]. Retrieved from https://www.youtube.com/watch?v=ArURYRYYacU

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