Pediatric Surgery International

, Volume 34, Issue 1, pp 55–61 | Cite as

Bronchoscopic assessments and clinical outcomes in pediatric patients with tracheomalacia and bronchomalacia

  • Yuichi Okata
  • Tomomi Hasegawa
  • Yuko Bitoh
  • Kosaku Maeda
Original Article



Tracheomalacia and bronchomalacia (TM/BM) are one of the serious causes of airway obstruction in infants and children. This study reviewed our bronchoscopic assessments and clinical outcomes in pediatric patients with TM/BM, and investigated risk factors of surgical intervention for TM/BM.


Fifty-seven consecutive patients who were diagnosed as TM/BM by bronchoscopy between 2009 and 2013 were reviewed retrospectively. They were divided into two groups according to the presence (group E, n = 26) or absence (group N, n = 31) of acute life-threatening events and extubation failure (ALTE/EF). The severity of TM/BM was evaluated by Oblateness Index which was obtained from bronchoscopic images.


Oblateness Index was significantly higher in Group E than in Group N. Patients in Group E underwent surgical intervention for TM/BM more frequently, and had significantly longer intubation period and hospital stay. Clinical symptoms of ALTE/EF, Oblateness Index ≥ 0.70, and multiple malacic lesions were significant risk factors indicating surgical events in patients with TM/BM.


Patients with TM/BM who had ALTE/EF had more severe malacic lesions indicating surgical intervention, and worse clinical outcomes. Oblateness Index is a simple and semi-quantitative index for bronchoscopic assessment of TM/BM, and can be one of the prognostic tools to predict clinical severity of pediatric TM/BM.


Tracheomalacia Bronchomalacia Acute life-threatening event Surgical intervention 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The present study was approved by our institutional review board, and the need for informed consent was waived for the retrospective review of clinical medical records and databases.

Human participants and animal statements

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Yuichi Okata
    • 1
    • 3
  • Tomomi Hasegawa
    • 2
  • Yuko Bitoh
    • 1
    • 3
  • Kosaku Maeda
    • 1
  1. 1.Department of Pediatric SurgeryKobe Children’s HospitalKobeJapan
  2. 2.Department of Cardiovascular Surgery and Pediatric Critical Care MedicineKobe Children’s HospitalKobeJapan
  3. 3.Division of Pediatric Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan

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