Congenital Anomalies of the Tracheobronchial Tree: A Meta-Analysis and Clinical Considerations

Wong, L. T. K.; Cheruiyot, Isaac; Oliveira, Maria Helena Santos de; Keet, Kerri; Tomaszewski, Krzysztof A.; Walocha, Jerzy; Tubbs, Shane; Henry, Brandon Michael

doi:10.1016/j.athoracsur.2020.08.060

Cited by 8 publications

(11 citation statements)

References 48 publications

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“…In our previous work, we found that most studies used X‐ray to diagnose an AL, and the prevalence of AL obtained from X‐ray studies (2.6%) was significantly lower than that from CT studies (6.7%) (Yurasakpong et al, 2021 ), suggesting that radiographs are less sensitive in detecting the AL. The TB was present in only two patients, a prevalence of 0.2%, which is five times less common than the global average of 1.0% (Wong et al, 2021 ). The CB was not encountered, possibly because the sample size was insufficient.…”

Section: Discussionmentioning

confidence: 97%

Anatomical variants identified on chest computed tomography of 1000+ COVID‐19 patients from an open‐access dataset

et al. 2022

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Chest computed tomography (CT) has been the preferred imaging modality during the pandemic owing to its sensitivity in detecting COVID‐19 infections. Recently, a large number of COVID‐19 imaging datasets have been deposited in public databases, leading to rapid advances in COVID‐19 research. However, the application of these datasets beyond COVID‐19‐related research has been little explored. The authors believe that they could be used in anatomical research to elucidate the link between anatomy and disease and to study disease‐related alterations to normal anatomy. Therefore, the present study was designed to investigate the prevalence of six well‐known anatomical variants in the thorax using open‐access CT images obtained from over 1000 Iranian COVID‐19 patients aged between 6 and 89 years (60.9% male and 39.1% female). In brief, we found that the azygos lobe, tracheal bronchus, and cardiac bronchus were present in 0.8%, 0.2%, and 0% of the patients, respectively. Variations of the sternum, including sternal foramen, episternal ossicles, and sternalis muscle, were observed in 9.6%, 2.9%, and 1.5%, respectively. We believe anatomists could benefit from using open‐access datasets as raw materials for research because these datasets are freely accessible and are abundant, though further research is needed to evaluate the uses of other datasets from different body regions and imaging modalities. Radiologists should also be aware of these common anatomical variants when examining lung CTs, especially since the use of this imaging modality has increased during the pandemic.

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Section: Discussionmentioning

confidence: 97%

Anatomical variants identified on chest computed tomography of 1000+ COVID‐19 patients from an open‐access dataset

et al. 2022

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“…Three hypotheses have been proposed to explain its formation: reduction of a previously developed bronchus, migration of part of the developed hyparterial branching pattern to a different location, either on the trachea or a bronchus, and local morphogenesis [37]. A meta-analysis reported that the overall prevalence of TB was 1.0% [15]. Similar to the AL, the TB was 15 times more common (14.9%) in individuals with congenital anomalies, which suggests that TB occurrence may be influenced by genetics.…”

Section: Discussionmentioning

confidence: 99%

“…The AL is a rare (0.3% of the population) accessory lobe of the right lung, in which the upper lobe is divided by a misplaced azygos vein [14]. With a prevalence of 1.0% [15], the TB is a rare anatomical variant where an additional bronchus arises from the trachea before it enters the lungs. While many of these variations are asymptomatic and do not require treatment, they can sometimes cause discomfort, compression of nearby structures, or confusion in the interpretation of imaging studies.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Variants Identified on Computed Tomography of Oropharyngeal Carcinoma Patients

et al. 2023

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Background and Objectives: Anatomical variations in the head, neck and chest are common, and are observed as occasional findings on computed tomography (CT). Although anatomical variations are mostly asymptomatic and do not cause any negative influence on the body function, they may jeopardize diagnosis and may be confused with pathological conditions. The presence of variations may also limit surgical access during tumor removal. The aim of this study was to investigate the prevalence of six anatomical variations—os acromiale, episternal ossicles, cervical rib, Stafne bone cavity, azygos lobe and tracheal bronchus—in an open-access computed tomography dataset obtained from oropharyngeal cancer patients. Materials and Methods: A total of 606 upper-chest and neck computed-tomography scans (79.4% male and 20.6% female) were retrospectively investigated. Sex difference was evaluated using the z-test for two proportions. Results: Os acromiale, episternal ossicles, cervical rib, Stafne bone cavity, azygos lobe, and tracheal bronchus were present in 3.1%, 2.2%, 0.2%, 0%, 0.3% and 0.5%, respectively, of all patients. Os acromiale was identified as meso-acromion in 86.6%, and as pre-acromion in 17.4%, of all acromia. Episternal ossicles were present unilaterally in 58.3%, and bilaterally in 41.7%, of all sterna. Only the cervical rib showed a sex difference in prevalence. Conclusions: awareness of these variations is important for radiologists interpreting head, neck and chest CTs; for example, those of oropharyngeal cancer patients. This study also illustrates the applicability of publicly available datasets in prevalence-based anatomical research. While most of the variations investigated in the present study are well-known, the episternal ossicles are not well explored, and need further investigation.

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“…Contrary to its overall anatomical structure, the tracheobronchial tree may also have distinctive characteristics and numerous variations [3]. The accessory cardiac bronchus (ACB) and tracheal bronchus (TB) are frequently major anomalies or variations in the tracheobronchial tree [41]. The accessory cardiac bronchus is an excess bronchus that extends from the inner wall of the right main bronchus or intermediate bronchus to the pericardium [13],…”

Section: Introductionmentioning

confidence: 99%

“…whereas the tracheal bronchus is an abnormal or accessory bronchus that primarily arises from the right lateral wall of the trachea [26]. Tracheobronchial abnormalities occur between 0.1% and 2% of the time [41]. Clinical practice should take anatomical variances into account [43].…”

Section: Introductionmentioning

confidence: 99%

Systematic literature study of trachea and bronchus morphology in children and adults

2023

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Congenital Anomalies of the Tracheobronchial Tree: A Meta-Analysis and Clinical Considerations

Cited by 8 publications

References 48 publications

Anatomical variants identified on chest computed tomography of 1000+ COVID‐19 patients from an open‐access dataset

Anatomical variants identified on chest computed tomography of 1000+ COVID‐19 patients from an open‐access dataset

Anatomical Variants Identified on Computed Tomography of Oropharyngeal Carcinoma Patients

Systematic literature study of trachea and bronchus morphology in children and adults

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