In diffuse tracheal disease or extensive peritracheal adhesions, the trachea usually distends unevenly during inspiration and collapses during expiration, thus interfering with the tracheal function. Expiratory stridor may worsen with supine position, crying and respiratory infections. Feeding difficulties sometimes reported. Hoarseness, aphonia and breathing may also be reported. Thoracic deformity may be present in chronic cases especially in younger patients.
Auscultation reveals normal inspiration but abnormal expiratory noises.
Not uncommonly, infant may demonstrate signs of growth failure. The indication for tracheostomy is severe symptoms, failure of conservative therapy, proximal or diffuse tracheomalacia. The indications for aortopexy are dying spells or reflex apnea, recurrent pneumonia, intermittent respiratory obstruction, inability to extubate airway. Trachea commences at the cricoid cartilage and terminates at fifth thoracic vertebra, lengthens and dilates during inspiration whereas narrows and shortens during expiration. Fifteen to twenty incomplete rings of cartilage prevent it from collapsing.