{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:45:55Z","timestamp":1785750355780,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tracheobronchomalacia (TBM) is estimated to be present in 1 in 2100 children. Previous reports suggest the prevalence is higher in children with cystic fibrosis (CF). This has clinical implications with potential to influence airway clearance and lung health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the prevalence and clinical associations of TBM in Western Australian children with CF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with CF born between 2001 and 2016 were included. Operation reports from bronchoscopies performed until the age of 4 were retrospectively reviewed. Data were collected on the presence, persistence defined as a repeat diagnosis, and severity of TBM. Data on genotype, pancreatic status, and symptoms at CF diagnosis were extracted from the medical record. Associations between categorical variables were compared using <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> and Fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 167 children (79 male), 68 (41%) were diagnosed with TBM at least once, with TBM persistent in 37 (22%) and severe in 31 (19%). TBM was significantly associated with pancreatic insufficiency (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20097.874, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, odds ratio [OR] 3.4), delta F508 gene mutation (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20096.489, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, OR 2.3), and a presentation of meconium ileus (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20098.615, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, OR 5.0). Severe malacia was less likley in females (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> = 4.523, <jats:italic>p &lt;<\/jats:italic> 0.05, OR 0.42)\u2009. No significant relationship was found with respiratory symptoms at the time of CF diagnosis (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.742, <jats:italic>p<\/jats:italic>\u2009=\u20090.39).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TBM was common in this group of children under the age of 4 with CF. A high index of suspicion for airway malacia should be considered in children with CF, particularly those who present with meconium ileus and have gastrointestinal symptoms at diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26550","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T13:11:11Z","timestamp":1686316271000},"page":"2568-2573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence of tracheobronchomalacia is higher than previously reported in children with cystic fibrosis"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5561-3427","authenticated-orcid":false,"given":"Julie","family":"Depiazzi","sequence":"first","affiliation":[{"name":"Perth Children's Hospital Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal","family":"Bourke","sequence":"additional","affiliation":[{"name":"Perth Children's Hospital Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Stick","sequence":"additional","affiliation":[{"name":"Perth Children's Hospital Nedlands Western Australia Australia"},{"name":"Wal\u2010yan Respiratory Research Centre Nedlands Western Australia Australia"},{"name":"Telethon Kids Institute  Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Withers","sequence":"additional","affiliation":[{"name":"Perth Children's Hospital Nedlands Western Australia Australia"},{"name":"Wal\u2010yan Respiratory Research Centre Nedlands Western Australia Australia"},{"name":"Telethon Kids Institute  Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00382-2019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.3.984"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.5.3391"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","unstructured":"ZirekF OzcanG CanOS CobanogluN.A retrospective analysis of children with lower airway malacia in a tertiary paediatric hospital.Authorea. 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