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The Ring-and-Sling complex - Does it "Ring" true?

Manjusha Ray1, Pragati Sathe1, Pradeep Vaideeswar1

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Indian Journal of Pathology & Microbiology
|October 21, 2021
PubMed
Summary
This summary is machine-generated.

The infantile trachea, including in Ring-and-Sling complex cases, features cartilage plates rather than complete rings. This histological finding has surgical implications for congenital tracheal stenosis.

Keywords:
Congenital anomaliesHistologyRing-and-Sling complexTrachea

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Area of Science:

  • Pediatric Pathology
  • Thoracic Surgery
  • Histology

Background:

  • The Ring-and-Sling complex (RSC) involves congenital tracheal stenosis and abnormal left pulmonary artery.
  • Tracheal narrowing in RSC is often attributed to complete "O"-shaped cartilage rings.

Observation:

  • Histological examination of an infant with RSC revealed cartilaginous plates and fibro-elastotic tissue, not complete rings.
  • A study of 35 infant tracheas (normal and RSC) analyzed histology at multiple levels.

Findings:

  • Only 20.5% of studied tracheal sections showed complete semicircular cartilage rings.
  • The majority (79.5%) exhibited multiple cartilage plates, with plates more common than rings across all levels.
  • No significant association was found between ring/plate morphology and age, sex, or gestational age.

Implications:

  • The typical "ring" in infantile tracheas is composed of cartilage plates, not complete rings.
  • Understanding this histology is crucial for surgical interventions in congenital tracheal anomalies.
  • Accurate histological assessment may improve surgical outcomes for conditions like RSC.