Major anatomical variations of the tracheobronchial tree: bronchoscopic observation

Fiberoptic and rigid bronchoscopy are widely used diagnostic and therapeutic tools in pulmonary medicine. Investigators often neglect the bronchial variations; however, bronchial variations may have important implications for bronchoscopy, brachytherapy, pulmonary resections and intubations. It is accepted that anatomic variations of the airways are due to anomalies in the development of the lungs. As a result, lung buds grow to an inappropriate number or arise at atypical sites. In the present study, we tried to determine the incidence of bronchial variations in our region. We investigated 2550 consecutive reports of bronchoscopy retrospectively. Major variations of the tracheobronchial tree were found in 2.6% of patients examined by bronchoscopy. The most frequent finding was a bifurcate pattern in the right upper lobe (47.7%). The variations were localized to the right upper lobe in 71.6% of patients. Male predominance was observed in all anatomic variations except one.