Wheezing in the infant with bronchopulmonary dysplasia results from various pathophysiologic mechanisms, including upper or central airway obstruction. We report an infant with bronchopulmonary dysplasia who presented with episodic wheezing associated with hypoxia and bradycardia without evidence of stridor. Bronchoscopy revealed the presence of tracheomalacia. Upper or central airway obstruction, if undiagnosed, may be life-threatening. We suggest that wheezing with hypoxia and bradycardia in neonates should alert the physician to the possibility of tracheomalacia, even in the absence of audible stridor. Infants presenting with these symptoms should undergo bronchoscopy to confirm the diagnosis.
JohnerCHSzantoPA. Polychondritis in a newborn presenting as tracheomalacia. Ann Otol Rhinol Laryngol1970; 79: 1114–6.
8.
ChenHChangCPerrinEPerrinJ. A lethal, Larsen-like multiple joint dislocation syndrome. Am J Med Genet1982; 13: 149–61.
9.
ArditoJMOssoffRHTuckerGFJrDeLeonSY. Innominate artery compression of the trachea in infants with reflex apnea. Ann Otol Rhinol Laryngol1980; 89: 401–5.
10.
BenjaminB. Tracheomalacia in infants and children. Ann Otol Rhinol Laryngol1984; 93: 438–42.
11.
BenjaminB. Endoscopy in esophageal atresia and tracheoesophageal fistula. Ann Otol Rhinol Laryngol1981; 90: 376–82.
12.
WailooMPEmeryJL. The trachea in children with trachea-oesophageal fistula. Histopathology1979; 3: 329–38.
13.
WittenborgMHGyepesMTCrockerD. Tracheal dynamics in infants with respiratory distress, stridor, and collapsing trachea. Radiology1967; 88: 653–62.
14.
MillerRNWooPKellmanRKSlagleTS. Tracheobronchial abnormalities in infants with bronchopulmonary dysplasia. J Pediatr1987; 111: 779–82.
15.
SotomayorJLGodinezRIBordenSWilmottRW. Large airway collapse due to acquired tracheobronchomalacia in infancy. Am J Dis Child1986; 140: 367–71.
16.
AbramsonALGoldsteinMNStenzlerASteeleA. The use of the tidal breathing flow volume loop in laryngotracheal disease of neonates and infants. Laryngoscope1982; 92: 922–6.
17.
GreenholzSKKarrerFMLillyJR. Contemporary surgery of tracheomalacia. J Pediatr Surg1986; 21: 511–4.
18.
CogbillTHMooreFAAccursoFJLillyJ. Primary tracheomalacia. Ann Thorac Surg1983; 35: 538–41.
