Clinical and demographic characteristics of tracheobronchial variations

Abstract

Background:There are various anatomic variations in tracheobronchial system (tracheal bronchus, ectopic bronchus, and accessory bronchus). We aimed to investigate the bronchoscopic findings of the patients with tracheobronchial variations (TBVs) during bronchoscopy and to describe their clinical characteristics.Materials and Methods:A total of 3322 records of bronchoscopic examinations in university hospital and 1560 in chest disease hospital total 4882 were retrospectively analyzed and 198 (134 male, 64 female) patients were diagnosed as TBV.Results:Mean age of patients was 48.5 ± 17.8 (range, 15–78) years. Most of the tracheobronchial variations (n = 68, 33.1%) were localized at the right upper lobe bronchus. The most common type of TBVs at this region was right upper lobe with two segments. Symptoms were found in 21 (10.2%) patients with TBVs (7 accessory cardiac bronchus, 5 tracheal bronchus, 5 accessory segmental bronchus in left main bronchus and 4 accessory segmental bronchus in right main bronchus). Their symptoms cough, hemoptysis and recurrent pneumonia with unknown etiologies were thought as related to TBVs. No other potential causes leading these symptoms were found in these patients.Conclusion:According to our best of knowledge our study population is one of the largest series of bronchoscopy for investigate of TBVs. Although TBVs were usually reported as asymptomatic, nearly 10% of our patients with TBVs had symptoms such as recurrent pneumonia, cough and hemoptysis. TBVs should be taken into consideration in symptomatic patients before fiber-optic bronchoscopic examination.

Variaciones anatómicas del árbol traqueobronquial en dos hospitales de referencia de Yucatán, México

“…15 A pesar de ello, la frecuencia de las variaciones bronquiales parece tener un comportamiento regional e inclusive es diversa entre individuos de la misma zona geográfica. 7,[18][19][20] Particularmente en México, Navarro et al reportaron que sólo 27% de los individuos sometidos a broncoscopia tenía la distribución bronquial normal; podemos suponer que 73% de dicha población presentaba alguna variación. 10 Nuestra serie, en el sureste del país, registró 35.5% de variantes, esta frecuencia, si bien menor a la citada en población mexicana, se encuentra entre los rangos descritos a nivel internacional.…”

“…Si bien nosotros no encontramos diferencias con base en el género, ha sido materia de discusión en otros reportes. Gonlugur y Abakay et al reportaron mayor predominancia de variaciones en los varones con respecto a las mujeres; 18,19 por otro lado, en series caucásicas mantienen la misma distribución. 7 Desde el punto de vista clínico, la mayoría de las variantes son asintomáticas, sin embargo cobran relevancia en escenarios donde se manifiestan procesos infecciosos y cuando se planea realizar una cirugía de resección pulmonar.…”

“…27 El hallazgo no esperado mediante broncoscopia debe alertar al médico en la búsqueda de alteraciones anatómicas (mediastinal) y funcionales (EPOC), el resto de las variaciones bronquiales reportadas en el presente trabajo tienen frecuencias similares a las reportadas por otros autores. 7,8,19 Entre las limitantes del presente trabajo se pueden enunciar la naturaleza retrospectiva y el escaso número de pacientes incluidos. Es posible que a pesar de que se descartaron las broncoscopias incompletas, hayan pasado inadvertidas variaciones sutiles de la segmentación bronquial.…”

Tracheobronchial variations evaluated by multidetector computed tomography and virtual bronchoscopy

“…TBVs are demonstrated in large series by bronchoscopy [6][7][8] . To our knowledge, there are a number of studies scan was acquired 30 s after the initiation of the injection (arterial phase).…”

Anatomy and physiology of respiratory system relevant to anaesthesia

“…Tracheobronchial tree exhibits a wide range of variations and its prevalence is 4%. [ 28 ] The most common main bronchus anomalies are the tracheal bronchus and the accessory cardiac bronchus. Knowledge of tracheobronchial variants is important for clinical aspect in pre-operative evaluation in view of intubation, lung isolation techniques and other endo-bronchial procedures.…”