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[Radiological assessment of the structural relationship between the trachea and the innominate artery in physically
N Iiyori1, K Miyasaka, Y Kitahara
1Department of Anesthesia, Chiba Children's Hospital, Chiba 266-0007.
Insights
Tracheo-innominate artery fistula in children with scoliosis may result from tracheal compression by the innominate artery. Three-dimensional helical CT (3 DCT) can help assess these structural relationships.
Area of Science:
- Medical Imaging
- Pediatric Surgery
- Anatomy
Background:
- Tracheostomy in pediatric patients, especially those with physical disabilities and scoliosis, carries risks.
- Tracheo-innominate artery fistula is a rare but life-threatening complication.
- Understanding the anatomical factors contributing to this fistula is crucial for prevention.
Purpose of the Study:
- To investigate the potential causes of tracheo-innominate artery fistula in physically disabled and scoliotic children.
- To clarify the role of anatomical variations and spinal deformity in fistula development.
Main Methods:
- Utilized three-dimensional helical computed tomography (3 DCT) for detailed anatomical assessment.
- Analyzed the spatial relationship between the trachea, vertebra, and innominate artery in affected children.
Main Results:
- Right scoliosis can lead to leftward tracheal displacement, causing the innominate artery to compress the trachea.
- Worsening scoliosis in disabled children may increase innominate artery compression on the trachea.
Conclusions:
- Periodic 3 DCT examination is recommended to monitor the structural relationship between the trachea, vertebra, and innominate artery.
- Early detection of anatomical changes can aid in preventing tracheo-innominate artery fistula in this vulnerable population.
Abstract:
Studies were made on the physically disabled and scoliotic children who underwent tracheostomy. The purpose was to clarify factors that might lead to the tracheo-innominate artery fistula, by use of three-dimensional helical CT (3 DCT). In a case of right scoliosis, the tracheo-innominate artery fistula may be caused by the left-ward displacement of the trachea from the vertebra, having the innominate artery ride over the trachea and compressing it. In a case of the physically disabled and scoliotic children, there may be more compression on the trachea by the innominate artery along with the worsening scoliosis. Therefore, we consider it necessary to examine the structural relationship between the trachea, the vertebra, and the innominate artery periodically by 3 DCT.