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Pediatric Large Airway Disorders: Summary

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In summary, keep in mind

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that the airway is an important structure to pay attention

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to on imaging When we're looking at a normal airway.

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Remember, there are variations of normal,

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particularly in young children,

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to include expiratory buckling,

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and we want to see the normal subglottic shouldering.

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If we happen to be imaging the patient in expiration on a

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frontal view of the congenital disorders,

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think about a couple things.

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Is the nasal passageway patent?

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If not, then think about piriform aperture stenosis

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or al atresia.

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If you're thinking more about the trachea

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or central bronchi

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and you're not sure about patency,

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consider a dynamic CT over time where you might be able

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to evaluate the cross-sectional area between inspiration

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and expiration of the infectious disorders.

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Remember, do you see a steeple sign?

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Think of croup if you do. Do you see pseudo membranes?

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Think of bacterial tracheitis. Do you see a thumbprint?

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Don't forget about epiglottitis.

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And finally, when thinking about neoplastic disorders,

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particularly think about whether you see unexpected

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asymmetry of the airway.

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And if you see some sort

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of post obstructive atelectasis on a chest ct,

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really scrutinized

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to check if there's an endobronchial lesion obstructing

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that airway to cause the atelectasis.

Report

Faculty

Grace S Mitchell, MD, MBA

Pediatric Radiologist

Children's Mercy Hospital Kansas City

Tags

Pediatrics

Neuroradiology

Lungs

Chest

Aerodigestive system