The trachea extends from the larynx above until the beginning of the bronchi. The trachea and bronchi can be considered to a tree with further ramifications of the bronchi into the lungs. There are 2 main bronchi - each for the right and left lung, which in turn divide into several segmentary bronchi. The trachea and bronchi are made of incomplete rings of cartilage, which maintains their architecture and stability during respiration. Tracheomalacia and/or bronchomalacia are conditions in which the airways are collapsible and do not allow sufficient oxygenation of the lungs. Symptoms of bronchomalacia vary but may include chronic cough, prolongation of lower respiratory tract infections, exercise intolerance, respiratory distress, apnea, recurrent pneumonia and recurrent bronchitis. The diagnosis of bronchomalacia is best made by examination of the bronchi in the operating room with a flexible telescope. Most children outgrow symptoms of bronchomalacia as they mature however some patients with very severe symptoms may have symptoms persisting beyond childhood. Its treatment can take several months and is one of the most difficult chronically affecting conditions of the entire airway. The condition can affect the proximal (upper) or distal (lower) trachea with or without bronchial involvement. Long distal tracheobronchomalacia is more troublesome to treat. Mild cases will improve with time. If the cause is due to compression of the trachea by a large vessel or mass in the chest, then the surgeons will discuss an operation. In case there is no such extrinsic cause, the treatment will be by a mask and positive airway ventilation or CPAP. Using the mask, air is forced into the collapsed airway to oxygenate the lungs. The time period for which this is required is variable and patient dependant.

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