Abstract：
Introduction: Lower airway malacia (LAM) is characterized by a reduction in the cross-sectional luminal area during quiet respiration. There is no gold standard diagnostic test; however, flexible fiberoptic bronchoscopy (FFB) is most frequently utilized. The exact prevalence and incidence of LAM are unknown. This study aimed to determine the prevalence rates of pediatric patients diagnosed with LAM, offer a detailed understanding of their demographic and clinical characteristics, and investigate distinctions between two specific types of LAM, namely, tracheomalacia (TM) and bronchomalacia (BM). Materials and Methods: Patients younger than 18 years diagnosed with LAM using FFB were included in this retrospective case series. Demographic and clinical characteristics and comorbid disorders were compared between patients with isolated BM and those with isolated TM or tracheobronchomalacia (TM/TBM). Results: Among 390 patients who underwent FFB, 65 (16.6%) were diagnosed with LAM, 16 (24.6%) with TM, and 56 (86.2%) with BM. The median age at diagnosis was 15 months. Among them, 59 (90.8%) had other comorbidities; gastrointestinal (GI) disorders were the most common (38.5%). The most common indications for bronchoscopy were recurrent/prolonged lower respiratory tract infections (LRTI) or wheezing (43.1%), while the most frequently observed respiratory physical examination finding was stridor (35.4%). Patients with TM/TBM had significantly higher frequencies of premature births, stridor, retraction, and GI disorders. Conclusion: Patients with stridor without typical laryngomalacia features or recurrent or prolonged LRTI should undergo prompt evaluation for LAM. The potential coexistence of GI disorders such as gastroesophageal reflux disease and swallowing dysfunction should also be considered.
摘要：
简介：下气道软化症（LAM）的特征是安静呼吸时横截面管腔面积减少。没有黄金标准的诊断测试；然而，柔性纤维支气管镜（FFB）是最常用的。LAM的确切患病率和发病率未知。这项研究旨在确定诊断为LAM的儿科患者的患病率，详细了解他们的人口统计学和临床特征，并研究两种特定类型的LAM之间的区别，即,气管软化（TM）和支气管软化（BM）。材料和方法：使用FFB诊断为LAM的18岁以下患者纳入本回顾性病例系列。比较了孤立的BM患者和孤立的TM或气管支气管软化症（TM/TBM）患者的人口统计学和临床特征以及合并症。结果：在390例接受FFB的患者中，65人(16.6%)被诊断为LAM，16（24.6%）与TM，和56（86.2%）与BM。诊断时的中位年龄为15个月。其中,59（90.8％）有其他合并症；胃肠道（GI）疾病是最常见的（38.5％）。支气管镜检查最常见的适应症是下呼吸道感染（LRTI）或喘息（43.1％），而最常见的呼吸道体检发现是喘鸣（35.4％）。TM/TBM患者的早产频率明显较高，stridor,撤回,和胃肠道疾病。结论：没有典型喉软化特征或复发或长期LRTI的喘鸣患者应及时进行LAM评估。还应考虑胃肠道疾病如胃食管反流病和吞咽功能障碍的潜在共存。
