A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

Su, Siew Choo; Buntain, Helen; Frawley, Kieran; Sarikwal, Anubhav; Watson, Debbie; Ware, Frances; Wuth, Jan; Chang, Anne B.

doi:10.1002/ppul.23606

Cited by 33 publications

(24 citation statements)

References 32 publications

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“…Gaarfar concludes that CTA is necessary in children with a high level of suspicion of vascular anomaly [28] and the current study would support this recommendation. Dynamic airway mulitdetector CT has also been shown to provide relatively accurate visualisation of a malacic airway, but lacks the ability to visualise mucosal morphology, vascularity and mucus plugs [26].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…LB had a sensitivity of 46.1%, specificity of 86.2% and positive predictive value of 42.9% for compressive tracheomalacia. The low sensitivity and positive predictive value suggest that it is difficult to assess the cause of malacia from inside the airway.A chest CTA has the distinct advantage of providing simultaneous evaluation of the mediastinal, vascular and lung pathologies, as well as visualisation of airways distal to the obstruction[26]. This can assist with diagnosis and surgical planning.…”

mentioning

confidence: 97%

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Paediatric tracheomalacia - A review of clinical features and comparison of diagnostic imaging techniques

Deacon

Widger

Soma

2017

International Journal of Pediatric Otorhinolaryngology

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

mentioning

confidence: 97%

Paediatric tracheomalacia - A review of clinical features and comparison of diagnostic imaging techniques

Deacon

Widger

Soma

2017

International Journal of Pediatric Otorhinolaryngology

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“…Virtual bronchoscopy is not very sensitive (sensitivity <75%) in detecting TM [59]. Only one study compared virtual bronchoscopy with flexible bronchoscopy, reporting a sensitivity of 54.1% and specificity of 87.5% for TM and 45.2% and 95.5% for BM [60].…”

Section: Multidetector Computed Tomographymentioning

confidence: 99%

ERS statement on tracheomalacia and bronchomalacia in children

et al. 2019

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Tracheomalacia and tracheobronchomalacia may be primary abnormalities of the large airways or associated with a wide variety of congenital and acquired conditions. The evidence on diagnosis, classification and management is scant. There is no universally accepted classification of severity. Clinical presentation includes early-onset stridor or fixed wheeze, recurrent infections, brassy cough and even near-death attacks, depending on the site and severity of the lesion. Diagnosis is usually made by flexible bronchoscopy in a free-breathing child but may also be shown by other dynamic imaging techniques such as low-contrast volume bronchography, computed tomography or magnetic resonance imaging. Lung function testing can provide supportive evidence but is not diagnostic. Management may be medical or surgical, depending on the nature and severity of the lesions, but the evidence base for any therapy is limited. While medical options that include bronchodilators, anti-muscarinic agents, mucolytics and antibiotics (as well as treatment of comorbidities and associated conditions) are used, there is currently little evidence for benefit. Chest physiotherapy is commonly prescribed, but the evidence base is poor. When symptoms are severe, surgical options include aortopexy or posterior tracheopexy, tracheal resection of short affected segments, internal stents and external airway splinting. If respiratory support is needed, continuous positive airway pressure is the most commonly used modality either via a face mask or tracheostomy. Parents of children with tracheobronchomalacia report diagnostic delays and anxieties about how to manage their child's condition, and want more information. There is a need for more research to establish an evidence base for malacia. This European Respiratory Society statement provides a review of the current literature to inform future study.

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“…Because the use of CT scans with their inherent radiation exposure is much more restricted in children, it is not clear if this modality can be used to detect pediatric tracheobronchomalacia obviating the need of an invasive examination such as a bronchoscopy in selected patients. Su et al reported the comparison of both methods in 53 children, when bronchoscopist‐radiologist pairs reviewed the results in blinded fashion. Thirty‐seven children (70%) had tracheobronchomalacia on flexible bronchoscopy, while only 20 were evident by virtual bronchoscopy (sensitivity 45.2%).…”

Section: Diagnostic Testing/endoscopymentioning

confidence: 99%

Pediatric Pulmonologyyear in review 2016: Part 1

et al. 2017

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

Cited by 33 publications

References 32 publications

Paediatric tracheomalacia - A review of clinical features and comparison of diagnostic imaging techniques

Paediatric tracheomalacia - A review of clinical features and comparison of diagnostic imaging techniques

ERS statement on tracheomalacia and bronchomalacia in children

Pediatric Pulmonologyyear in review 2016: Part 1

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