Sex differences in paediatric airway anatomy

Area of Science:

• Pulmonary Medicine
• Pediatric Radiology
• Anatomy

Background:

• Cross-sectional airway area is critical for airflow resistance.
• Previous studies on sex differences in pediatric airway size were limited by disease history or small sample sizes.
• Existing research often focused only on the trachea or did not account for height.

Purpose of the Study:

• To investigate sex differences in central airway luminal area in healthy children.
• To determine if these differences emerge at specific ages.
• To assess the influence of height on observed sex differences.

Main Methods:

• Retrospective analysis of high-resolution computed tomography (HRCT) scans.
• Three-dimensional reconstructions of central airways in healthy pediatric patients (ages 1-17).
• Measurement of cross-sectional airway area in trachea and main bronchi by a blinded investigator.

Main Results:

• No significant sex differences in airway luminal area were found in patients aged 1-12 years.
• In patients aged 14 years and older, males exhibited significantly larger central airway areas than females.
• These sex differences were reduced but remained significant after adjusting for patient height.

Conclusions:

• Sex differences in central airway size in healthy children become apparent after age 14.
• These differences are largely independent of height.
• Findings may help explain sex-based variations in pulmonary limitations during exercise in pediatric populations.