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Tracheomalacia
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
QUAD #26 - Use of Ultrashort Echo-Time MRI to Measure Tracheomalacia in Neonates with Esophageal Atresia with Dr. Douglas von Allmen
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In this QUAD Conference presentation, Dr. Douglas von Allmen from Cincinnati Children’s shares groundbreaking research on using ultrashort echo-time MRI to evaluate tracheomalacia in neonates with esophageal atresia (EA). This innovative im
video5:51 · Feb 2025
Preoperative determination of the need for aortopexy may alleviate chronic respiratory conditions and decrease the risk of future surgical intervention. — Basma Magdy, BOB Ped Surg 2023 - Basma Magdy, PAPSA - Presentation · 0:00
Posterior Tracheopexy For Severe Tracheomalacia
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Dr. Ian Glenn and Dr. Todd Ponskygive a two minute review of "posterior tracheopexy for severe tracheomalacia," and article published in the Journal of Pediatric Surgery.Dr. Hester Shieh and colleagues performed posterior tracheopexy on pat
video2:18 · Sep 2018
Posterior Tracheopexy during Primary Esophageal Atresia Repair
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Dr. Stefaan Tytgat discusses their experience with selective posterior tracheopexy in patients with intraoperatively diagnosed posterior tracheomalacia, during primary esophageal atresia repair. Article: http://ow.ly/agTW30lSY2u?externalLin
video · Oct 2018
BOB Ped Surg 2023 - Basma Magdy, PAPSA - Presentation
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Watch Dr. Basma Magdy present her presentation on "Thoracoscopic posterior tracheopexy in esophageal atresia patients, single institute experience."
video · Feb 2023
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
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Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway c
video5:26 · Dec 2023
QUAD #2 Thoracoscopic Tracheopexy with Dr. Aaron Garrison
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Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway c
video7:36 · Jan 2024
QUAD #17 - Innominate Artery Compression and Management Through The Neck - Dr. Doug von Allmen
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In this video, Dr. Doug von Allmen from Cincinnati Children’s Hospital shares insights into managing innominate artery compression using a transcervical approach. Originally described in the 1940s, this condition is seen in about 30% of chi
video5:32 · Sep 2024
The 50% sensitivity finding suggests it might be advisable to avoid primary therapeutic intervention at time of esophageal atresia repair and only treat patients who develop symptoms — Mikko Pakarinen, Journal of Pediatric Surgery Article Review: 4th Quarter (Oct-Dec) 2024 · 9:30
Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study
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David Basurto, Kanokwaroon Watananirun, Anne-Gael Cordier, Juan Otaño, Diane Carriere, Marianna Scuglia, Anna Moraes de Luna Freire Vargas, Jordi Prat, Francesca Maria Russo, Anne Debeer, Cleisson Fábio Andrioli Peralta, Paolo De Coppi, Edu
video0:59 · Oct 2024
Journal of Pediatric Surgery Article Review: 4th Quarter (Oct-Dec) 2024
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We are back with another episode of our Journal of Pediatric Surgery article review podcast.
This time we have three publications from the fourth quarter of 2024, October, November and December issues. This time we're talking to editors
podcast18:55 · Feb 2025
Quick Literature Updates Ep 19
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We’re back with nineteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most int
video4:27 · May 2025
Quick Literature Updates Ep 27
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We’re back with 27th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesti
video4:20 · Feb 2026
Rare findings on preoperative bronchoscopy include subglottic or molecular cysts that may have implications for respiratory support and postoperative course. — Matt Dellinger, 2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management · 5:40
2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management
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On August 26th, the largest Pediatric Surgery course in the world each year was held, where top hospital experts from around the US will discuss this year’s changes in practices and innovation. Learn more about the future of pediatric surge
video16:08 · Aug 2025
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Expert statements from the recordings in this collection.
Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study
Tracheomalacia was 5% more common in tracheal occluded infants with 4% more cases
clinicalCarlos Colunga0:24 ↗
Tracheomalacia symptoms typically receded within 55 months in FETO-treated infants
clinicalCarlos Colunga0:29 ↗
FETO-treated infants showed a larger trachea, approximately 31% wider
clinicalCarlos Colunga0:33 ↗
37% of tracheally occluded cases retained metallic balloon components
clinicalCarlos Colunga0:33 ↗
No significant complications were reported from retained metallic balloon components
clinicalCarlos Colunga0:33 ↗
Tracheal occlusion is effective in promoting lung growth
clinicalCarlos Colunga0:46 ↗
FETO is associated with a higher risk of tracheomalacia
clinicalCarlos Colunga0:46 ↗
Most cases of FETO-associated tracheomalacia resolve and do not appear to have long-term effects
clinicalCarlos Colunga0:46 ↗
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases.
clinicalAlessandro de Alarcon0:49 ↗
Preoperative testing includes dynamic CT imaging, pulmonary function tests, microlaryngoscopy and bronchoscopy, and flexible bronchoscopy.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position0:55 ↗
Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes.
clinicalAlessandro de Alarcon1:15 ↗
Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure.
clinicalAlessandro de Alarcon1:21 ↗
Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis.
clinicalAlessandro de Alarcon1:29 ↗
A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them.
clinicalAlessandro de Alarcon1:39 ↗
The surgical approach uses subplatysmal flaps and addresses anterior compression as needed.
clinicalAlessandro de Alarcon1:55 ↗
The cervical approach can assist thoracoscopic procedures by removing residual or regrown large thymus tissue.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:01 ↗
Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure.
clinicalAlessandro de Alarcon2:09 ↗
In the lateral approach, the surgical team works on the side of the airway to find the esophagus.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:19 ↗
Pediatric surgeons identify the recurrent nerve for the ENT team to help prevent injury.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:23 ↗
The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure.
opinionAlessandro de Alarcon2:29 ↗
The esophagus is mobilized above the level where the team aims to perform the pexy, making suture placement easier.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:43 ↗
Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine.
clinicalAlessandro de Alarcon2:54 ↗
A pulmonologist assists with flexible endoscopy through the endotracheal tube to visualize inside the trachea while stitches are placed.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position3:02 ↗
The team uses 3-0 prolene sutures and places all stitches before securing them down.
clinicalAlessandro de Alarcon3:15 ↗
Suture placement is performed under spontaneous ventilation conditions.
clinicalAlessandro de Alarcon3:15 ↗
The combined approach is valuable for complicated cases or patients needing additional operations for symptom relief.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position3:24 ↗
A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free.
clinicalAlessandro de Alarcon3:33 ↗
Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging.
clinicalAlessandro de Alarcon4:00 ↗
At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better.
clinicalAlessandro de Alarcon4:09 ↗
The team is still learning what measures should define good versus bad outcomes.
opinionAlessandro de Alarcon4:15 ↗
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