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Chest Mar 2019Tracheobronchial injury is a rare but a potentially high-impact event with significant morbidity and mortality. Common etiologies include blunt or penetrating trauma and... (Review)
Review
Tracheobronchial injury is a rare but a potentially high-impact event with significant morbidity and mortality. Common etiologies include blunt or penetrating trauma and iatrogenic injury that might occur during surgery, endotracheal intubation, or bronchoscopy. Early recognition of clinical signs and symptoms can help risk-stratify patients and guide management. In recent years, there has been a paradigm shift in the management of tracheal injury towards minimally invasive modalities, such as endobronchial stent placement. Although there are still some definitive indications for surgery, selected patients who meet traditional surgical criteria as well as those patients who were deemed to be poor surgical candidates can now be managed successfully using minimally invasive techniques. This paradigm shift from surgical to nonsurgical management is promising and should be considered prior to making final management decisions.
Topics: Bronchi; Conservative Treatment; Humans; Minimally Invasive Surgical Procedures; Patient Selection; Stents; Trachea; Wounds and Injuries
PubMed: 30059680
DOI: 10.1016/j.chest.2018.07.018 -
Folia Morphologica 2023Understanding the dimensions of the lower airway is critical for performing respiratory surgery, selecting and designing appropriate airway equipment, and removing... (Review)
Review
Understanding the dimensions of the lower airway is critical for performing respiratory surgery, selecting and designing appropriate airway equipment, and removing aspirated foreign bodies via bronchoscopy, anaesthesia, and radiography. The purpose of this study was to analyse the trachea and bronchus morphologically in children and adults, as well as to standardise the data for these structures' measurements. Various databases were reviewed for studies on lower airway dimensions. The criteria for inclusion and exclusion were established. Finally, it was agreed to look into 28 studies that took place between 1984 and 2021. The length of the trachea, its anterior-posterior (AP) and transverse dimensions, the lengths and transverse diameters of the right and left major bronchus, and the subcarinal angle were also investigated in the study. In studies where measurements were performed with different methods and procedures. It was revealed that age and gender were effective in the difference in lower respiratory tract dimensions. The mean values of all parameters were greater in adults than in children, the AP diameter of the trachea in adults was greater than the transverse diameter. In children, it was observed that the transverse diameter was larger than the AP diameter on average, the left main bronchus was longer than the right main bronchus, and the transverse diameter was smaller than the right main bronchus in most of the studies. The articles reviewed for this study revealed that measurements were done using a variety of different procedures and approaches, and the resulting data were inconsistent and could not be standardized. The data collected will be beneficial both conceptually and clinically; we believe that additional comparison research involving children and adults in bigger groups are necessary.
Topics: Adult; Child; Humans; Bronchi; Bronchoscopy; Databases, Factual; Tomography, X-Ray Computed; Trachea
PubMed: 36000591
DOI: 10.5603/FM.a2022.0073 -
Current Topics in Microbiology and... 2020Pulmonary respiration inevitably exposes the mucosal surface of the lung to potentially noxious stimuli, including pathogens, allergens, and particulates, each of which... (Review)
Review
Pulmonary respiration inevitably exposes the mucosal surface of the lung to potentially noxious stimuli, including pathogens, allergens, and particulates, each of which can trigger pulmonary damage and inflammation. As inflammation resolves, B and T lymphocytes often aggregate around large bronchi to form inducible Bronchus-Associated Lymphoid Tissue (iBALT). iBALT formation can be initiated by a diverse array of molecular pathways that converge on the activation and differentiation of chemokine-expressing stromal cells that serve as the scaffolding for iBALT and facilitate the recruitment, retention, and organization of leukocytes. Like conventional lymphoid organs, iBALT recruits naïve lymphocytes from the blood, exposes them to local antigens, in this case from the airways, and supports their activation and differentiation into effector cells. The activity of iBALT is demonstrably beneficial for the clearance of respiratory pathogens; however, it is less clear whether it dampens or exacerbates inflammatory responses to non-infectious agents. Here, we review the evidence regarding the role of iBALT in pulmonary immunity and propose that the final outcome depends on the context of the disease.
Topics: Bronchi; Humans; Immunity, Mucosal; Lymphocytes; Respiration
PubMed: 31974759
DOI: 10.1007/82_2019_191 -
Internal Medicine (Tokyo, Japan) Apr 2023
Topics: Humans; Bronchi; Bronchoscopy; Bronchial Diseases; Trachea
PubMed: 35945016
DOI: 10.2169/internalmedicine.0308-22 -
Scientific Reports Jan 2021The knowledge of airway length is the theoretical basis in the diagnosis and management of airway disease. The objective of this study is to measure the length of...
The knowledge of airway length is the theoretical basis in the diagnosis and management of airway disease. The objective of this study is to measure the length of trachea and left and right main bronchus in Chinese Shanghai population. A total of 153 consecutive adult patients with minor pulmonary disease in Xinhua hospital were enrolled for bronchoscopy examination. Measurements were conducted on head and neck neutral position and height, weight and age for each patient were recorded either. Student t test and multiple linear regression was used to compare means between males and females and to analyze correlation among height, weight, sexual dimorphism and the lengths of the trachea and bronchus. The lengths of the trachea and left main bronchus are significantly different between male and female patients (P < 0.01), but not for the lengths of right main bronchus between man and woman. Multiple linear regression analysis showed that height but not sexual dimorphism and weight correlated with the lengths of the trachea and right main bronchus. The lengths of the trachea and left main bronchus are significantly longer in males than in females. Moreover, height but not sexual dimorphism and weight influenced the length of airway.
Topics: Adult; Aged; Asian People; Bronchi; China; Female; Humans; Male; Middle Aged; Trachea; Young Adult
PubMed: 33500472
DOI: 10.1038/s41598-021-81744-0 -
Anaesthesia Jul 2016
Review
Topics: Bronchi; Humans; Tomography, X-Ray Computed; Trachea
PubMed: 27291599
DOI: 10.1111/anae.13531 -
Internal Medicine (Tokyo, Japan) Dec 2022
Topics: Humans; Bronchi; Bronchoscopy; Trachea
PubMed: 35466170
DOI: 10.2169/internalmedicine.9309-21 -
Interactive Cardiovascular and Thoracic... Jul 2022Lung parenchyma-sparing bronchial resection is uncommon, and the operative procedure depends on the cause and location of the stenosis. We present 6 cases and discuss...
Lung parenchyma-sparing bronchial resection is uncommon, and the operative procedure depends on the cause and location of the stenosis. We present 6 cases and discuss the different surgical strategies for sleeve resection of the central airway without lung resection. Bronchoplasty for the main bronchus and truncus intermedius was performed with a posterolateral approach. We resected the right main bronchus including the right lateral wall of the lower trachea and half of the carina obliquely and performed an anastomosis. The tumour in the left lobar bronchus was exposed and removed by transient division of the accompanying pulmonary artery. Although post-transplant stenosis and malacia can pose a challenge, bronchoplasty can be used as a definitive treatment in experienced centres.
Topics: Bronchi; Constriction, Pathologic; Humans; Pneumonectomy; Thoracic Surgical Procedures; Trachea
PubMed: 35699490
DOI: 10.1093/icvts/ivac166 -
Ear, Nose, & Throat Journal Sep 2022Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic disease with a stable course that involves the mucous membrane of the tracheobronchial tree. Most...
BACKGROUND
Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic disease with a stable course that involves the mucous membrane of the tracheobronchial tree. Most cases present no specific symptoms, and there are currently no established guidelines for diagnosis and treatment. In this report, we discuss a single case of a patient with TO who was diagnosed based on clinical imaging and histopathology.
CASE SUMMARY
A patient with a history of smoking and alcohol consumption, but no specific clinical symptoms, was diagnosed with TO after undergoing fiber-optic bronchoscopy. Nodular processes with smooth surface mucosa and detached bronchial mucosa were observed. The presence of TO was confirmed by pathological examination.
CONCLUSION
The diagnosis of TO is difficult, and early fiber-optic bronchoscopy and pathological examination should be performed to facilitate the diagnosis.
Topics: Bronchi; Bronchoscopy; Humans; Osteochondrodysplasias; Tracheal Diseases
PubMed: 33124932
DOI: 10.1177/0145561320969445 -
Advances in Immunology 2010Bronchus-associated lymphoid tissue (BALT) is a constitutive mucosal lymphoid tissue adjacent to major airways in some mammalian species, including rats and rabbits, but... (Review)
Review
Bronchus-associated lymphoid tissue (BALT) is a constitutive mucosal lymphoid tissue adjacent to major airways in some mammalian species, including rats and rabbits, but not humans or mice. A related tissue, inducible BALT (iBALT), is an ectopic lymphoid tissue that is formed upon inflammation or infection in both mice and humans and can be found throughout the lung. Both BALT and iBALT acquire antigens from the airways and initiate local immune responses and maintain memory cells in the lungs. Here, we discuss the development and function of BALT and iBALT in the context of pulmonary immunity to infectious agents, tumors, and allergens as well as autoimmunity and inflammatory diseases of the lung.
Topics: Animals; Bronchi; Humans; Immunity, Mucosal; Lymphocyte Activation; Lymphocytes; Lymphoid Tissue; Respiratory Mucosa
PubMed: 21034975
DOI: 10.1016/B978-0-12-381300-8.00007-1