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Tracheal bronchus: classification, endoscopic analysis, and airway management
Andrew M Doolittle1, Eric A Mair
1Otolaryngology-Head and Neck Surgery Service, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Summary
Tracheal bronchus is a rare congenital anomaly where the right upper lobe originates from the trachea. Awareness and bronchoscopy are key for diagnosis and management of this airway abnormality in children.
Area of Science:
- Pediatric Pulmonology
- Congenital Airway Anomalies
- Otolaryngology
Background:
- Tracheal bronchus (bronchus suis) is a congenital anomaly affecting the right upper lobe's origin.
- This condition requires specialized knowledge for accurate diagnosis and management.
Observation:
- A retrospective case series analyzed 5 pediatric cases over 12 years (0.5% of bronchoscopies).
- The anomaly was located in the right lateral trachea, more common in males and associated with other congenital anomalies.
- Three types were identified: vestigial tracheal diverticulum, high apical lobe, and fully developed supranumerary aerated tracheal bronchus.
Findings:
- Bronchoscopy confirmed the anomaly, revealing three distinct types.
- Clinical presentations included stridor, cough, recurrent pneumonia, and ruling out foreign body aspiration.
- Treatment varied from observation to right upper lobectomy based on symptom severity.
Implications:
- Otolaryngologists must recognize tracheal bronchus, its classification, and endoscopic findings.
- Bronchoscopy combined with imaging aids in comprehensive evaluation and timely therapeutic decisions for this uncommon condition.