Respiratory tract involvement affects 40-56% of patients and may involve any portion of the respiratory tree, including the distal bronchi. Tenderness to palpation may be present over the anterior trachea or thyroid cartilage.
The airways superior to the thoracic inlet collapse upon inspiration, and those below collapse upon expiration; therefore, both inspiratory and expiratory wheezing may be noted upon auscultation. Patients may presenting with inflammation and swelling of the glottis, larynx, and subglottic tissues may require tracheostomy
Chondritis weakens the tracheal cartilage rings, leading to wheezing, dyspnea, cough, and hoarseness. The airways eventually become flacid and/or stenosed and are replaced by collapsible fibrotic tissue.
The cases of acquired tracheomalacia occur with increasing frequency both in children and adults and are often not clearly recognized. These lesions usually cause focal tracheomalacia and may result from indwelling tracheostomy and endobronchial tube, chest trauma, chronic tracheobronchitis, and inflammation (relapsing polychondritis). They may be secondary to pulmonary resection and tracheal malignancy (cylindroma), and they may be idiopathic.
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Tracheal obstruction Trauma (eg, strangulation)
Prolonged intubation, Sarcoidosis, Wegener granulomatosis, Respiratory tree chondritis Perichondritis of the larynx due to herpes, syphilis, erysipelas, tonsillitis, peritonsillar abscess, tuberculosis, measles, diphtheria, scarlet fever, avitaminosis, blastomycosis, actinomycosis, Wegener granulomatosis, xanthoma, typhus, Vincent infection, anthrax, or smallpox may also cause chronditis of the respitory tract.
