Related Experiment Videos
[Bronchogenic cysts in the carina]
M Koskas1, G Tournier, A Baculard
1Service de Pédiatrie et Pneumologie de l'Enfant, Hôpital Trousseau, Paris.
Insights
Early surgery for pediatric carinal bronchogenic cysts is crucial. Prompt intervention prevents severe respiratory sequelae in children with these rare airway tumors.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Pulmonology
Context:
- Carinal bronchogenic cysts are rare congenital anomalies affecting the airway.
- Symptoms include acute respiratory distress and recurrent bronchiolitis in infants and young children.
- Diagnostic imaging plays a key role in identifying these mediastinal masses.
Purpose:
- To review the surgical management and outcomes of children with carinal bronchogenic cysts.
- To evaluate the effectiveness of early surgical intervention in preventing long-term respiratory complications.
Summary:
- Eleven children (1 month to 5 years) with symptomatic carinal bronchogenic cysts underwent surgery.
- Diagnostic findings included unilateral over-inflation (10/11), extrinsic compression (10/11), and low-density masses on CT (4/4).
- Surgical outcomes were generally good (10/11), though some experienced post-operative bronchial dyskinesia (5/6) or required pneumonectomy (2/11).
Impact:
- Highlights the necessity of early surgical treatment for carinal bronchogenic cysts to avoid permanent respiratory damage.
- Emphasizes the importance of multidisciplinary evaluation for optimal patient management.
- Provides insights into the potential long-term respiratory sequelae, including bronchial dyskinesia and pulmonary hypoplasia.
Abstract:
Between 1977 and 1990, 11 children with carinal bronchogenic cysts were operated in our institution: 8 girls and 3 boys, ranging in age from 1 month to 5 years. All were symptomatic (acute respiratory distress and recurrent bronchiolitis). Chest X-ray showed an unilateral over distension in 10/11 cases. Barium oesophagogram showed a compression in 6/10 cases. Bronchoscopy noticed an extrinsic compression in 10/11 cases and a tracheal and/or bronchial diskinesia in 5/11 cases. The computed tomography showed a low density mass in 4/4 cases. 9 cysts were left-sided and 2 right-sided. Both children underwent a second surgery for a second cyst. 2 pneumonectomies for complete parenchyma destruction were realised. 1 left pulmonary hypoplasia was noticed. A tracheal and/or bronchial diskinesia in post-operative was noticed in 5/6 cases. The clinical and functional respiratory following was good in 10/11 cases. An early surgery treatment is necessary before definitive sequelae.