Respiratory Findings and Growth Parameters in Pediatric Patients with Airway Malacia

INTRODUCTION Tracheomalacia (TM), bronchomalacia (BM), and tracheobronchomalacia (TBM) are major causes of dynamic airway collapse in children, leading to recurrent respiratory symptoms and increased morbidity. This study aimed to evaluate anthropometric parameters at diagnosis in pediatric patients with airway malacia diagnosed via flexible fiberoptic bronchoscopy (FFB), and to interpret their clinical significance. METHODS This retrospective study included pediatric patients diagnosed with airway malasia diagnosed by FFB between January 2019 and February 2025. Anthropometric measurements obtained at the time of diagnosis were evaluated according to the U.S. Centers for Disease Control and Prevention’s 2000 growth charts. Acute malnutrition was defined as weight-for-length or BMI-for-age z-scores < − 2, chronic malnutrition as height-for-age z-scores < − 2, and severity was classified according to z-score cutoffs. RESULTS Among 1,248 pediatric patients who underwent FFB, 129 (10.3%) diagnosed airway malacia: 32 (24.8%) had TM, 51 (39.5%) had BM, and 46 (35.7%) had TBM. Among these patients, the median age was 1.2 years (interquartile range: 0.5–3.2), and 79 (61.2%) were male. Additionally, 31 (24.8%) had acute malnutrition, and 26 (20.2%) had chronic malnutrition. Patients with TBM had significantly lower body weights and height z -scores than those with BM ( p  = 0.022 and 0.008, respectively). Among patients aged < 2 years, the weight-for-age percentile and z -score were significantly lower among those with TBM than among those with BM ( p  = 0.046 and 0.043, respectively). Among patients aged ≥ 2 years, the height-for-age percentile and z -score were significantly lower among those with TM and TBM than among those with BM (both p  = 0.002; TM vs. BM: p  = 0.009; TBM vs. BM: p  = 0.008). Body mass index and related parameters did not differ significantly between malacia subtypes. CONCLUSIONS Growth impairment is common in pediatric patients with airway malacia, particularly among those with TBM. Anthropometric evaluation should be an integral part of clinical assessment at the time of diagnosis to identify those at risk of growth failure.