Tracheomalacia, bronchomalacia and laryngomalacia are conditions where there is a deficiency in the functioning of the cartilage in the airway walls, which causes them to be weaker or even absent in places. This leads to an exaggerated luminal narrowing within the affected airway during expiration. The malacia may be localised or generalised. There is limited literature and published research in this area. These three conditions are seen in both children and adults. However, because of the size of the airways in small children and the more marked clinical response to any narrowing of the airway, these malacias are usually diagnosed at an earlier stage than when the conditions occur in adults. In the fully mature airway, the symptoms may be less obvious, leading to the conditions
being under-recognised and under-diagnosed in adults. It is also important to understand that in the adult population malacia may coexist with more common conditions such as asthma or chronic obstructive pulmonary disease (COPD), where breathlessness, cough, dyspnoea and other symptoms may be misattributed to these more common diseases.
This article raises awareness of these three malacia conditions.