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Airway compression in children with abnormal thoracic configuration
1Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Insights
Abnormal thoracic configuration can cause severe airway compression in children, leading to respiratory distress. Surgical correction of thoracic deformities resolved airway symptoms in most patients studied.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Medical Imaging
Background:
- Abnormal thoracic configuration can lead to restrictive lung disease in children.
- Severe airway compression is a critical complication of thoracic deformities.
Purpose of the Study:
- To evaluate clinical and imaging findings in pediatric patients with severe tracheal or bronchial compression.
- To understand the relationship between thoracic configuration and airway obstruction.
Main Methods:
- Retrospective review of six pediatric patients with airway compression due to abnormal thoracic configuration.
- Analysis of clinical data, surgical outcomes, and imaging findings (radiographs and magnetic resonance imaging).
Main Results:
- Airway compression resulted from mediastinal anatomical changes and narrow chest diameter.
- Tracheal or left main bronchial compression occurred in equal proportions of patients.
- Surgery for thoracic deformity resolved airway symptoms in four patients, with imaging findings confirmed intraoperatively.
Conclusions:
- Abnormal thoracic configuration is a significant cause of respiratory distress in children due to central airway compression.
- Magnetic resonance imaging is effective in identifying the location and cause of airway obstruction.
- Surgical intervention for thoracic deformities can successfully alleviate airway compression and symptoms.
Purpose:
To assess the clinical and imaging findings in children with severe tracheal or bronchial compression caused by abnormal thoracic configuration.
Materials And Methods:
Clinical and imaging findings, care, and outcome were reviewed in six patients with airway compression caused by abnormal thoracic configuration. Radiographs and magnetic resonance (MR) images were available in all patients.
Results:
Mechanisms of airway compression included alteration of mediastinal anatomy and direct airway compression secondary to a narrow anteroposterior chest diameter. In three patients, the trachea was compressed at the level of the thoracic inlet. In the other three patients, the left main bronchus was compressed. Four patients underwent surgery for the thoracic deformity, with resolution of airway symptoms. In all four patients, the presence, location, and cause of airway obstruction determined at MR imaging were confirmed at surgery.
Conclusion:
Abnormal thoracic configuration, in addition to causing restrictive lung disease, can cause respiratory distress secondary to severe compression of the central airways.