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The objective: to analyze results of TBNA for diagnosis of mediastinal lymphadenopathy performed with flexible and rigid tracheobronchoscopy with needles of different diameters.Subjects and Methods. We analyzed data of 194 patients who underwent TBNA with fibrobronchoscopy (Group 1) or rigid bronchoscopy (Group 2) for mediastinal lymphadenopathy of uncertain etiology.Results. The overall diagnostic efficacy of the biopsy was 90,7%, while in case of tumors, the sensitivity was 89,5% and specificity was 97,5%, in case of respiratory sarcoidosis, they were 92,5% and 85,9%, respectively. Better diagnostic efficacy rates were observed in Group 1 (flexible bronchoscopy with 19G puncture needles) versus Group 2 (rigid bronchoscopy with 16G puncture needles) which may be due to the small number of biopsies in Group 2.

Tracheal disruption is a previously unreported complication of nonhuman primate social trauma. Two cases were identified in rhesus macaques with subcutaneous emphysema. These cases resolved with medical management and demonstrate that the combined use of radiography and tracheoscopy allows rapid assessment and diagnosis of tracheal trauma in nonhuman primates. [ABSTRACT FROM AUTHOR]

Aim: Controversies exist on the optimal diagnostic workup for neonates with esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). Aim of this study was to describe the current diagnostic policies in EA/TEF patients enrolled in an International multicenter registry.Methods: All patients consecutively registered from July 2014 to December 2017 in the EUPSA Esophageal Atresia Registry (EUPSA-EAR) were included in the study. Data related to diagnostic investigations among Centers forming the EUPSA-EAR were analyzed.Main Results: During the study period, 374 consecutive patients were recorded by 23 Centers. The majority of patients underwent chest X-rays, echocardiography, abdominal ultrasound, and abdominal X-rays. Preoperative bronchoscopy and esophageal gap measurement were performed in one third of the patients.Conclusions: Present data from a large cohort of patients from the EUPSA-EAR show both inter-institutional and intra-institutional variability in diagnostic workup of patients with EA/TEF. Efforts should be made to develop guidelines on the diagnostic workup for EA/TEF patients.

Urrently, the problem of foreign bodies in the airways of children continues to be relevant. Aim - to assess the effectiveness of diagnostics and treatment of children with foreign bodies in tracheobronchial tree. Materials and methods. In the Department of otorhinolaryngology, the SBHI of MAMRRCI n.a. M.F. Vladimirskiy, we performed an integrated research of 189 children of different age, who had aspirated foreign bodies in the airways. We studied anamnestic, clinical, roentgenological and endoscopic criteria for the diagnosis of this pathology; we also studied the frequency of clinical complications caused by aspiration. Results. Follow-up observation of these children shows a significant frequency of remaining changes in the lungs after removal of foreign bodies. Discussion. In our opinion, for correct diagnosis and provision of qualified care to sick children it is necessary to raise awareness of parents and primary care physicians about the dangers of this pathology. If there is a reason to suspect a foreign body in the airways, consultation in a specialized institution is vitally important. The only correct method of treating children with foreign body in the airways, even at the slightest suspicion, is timely performed tracheobronchoscopy.

The article is devoted to bronchiectases issue in children and reflects the most actual approaches to the diagnosis and management of patients with this pathology. Information on the true prevalence of bronchiectases both abroad and in Russia varies. Wherein, bronchiectases can be either an independent disease or a manifestation of another pathology, which necessitates an integrated multidisciplinary approach not only for diagnosis but also for patient management with this pathology. The material presented by the authors is based on clinical guidelines developed and approved by the profile association of the Union of Pediatricians of Russia and aimed at raising awareness of specialists providing medical care to children.

Esophageal atresia (EA) repair has always been a source of immense professional gratification for the pediatric surgeon. In many ways, this anomaly defines the entire profession. Due to its rarity, there is an increased risk of inadvertent events occurring during correction. This article describes some of the error traps that may occur in attempting esophageal reconstruction and how they may be avoided. [ABSTRACT FROM AUTHOR]

Filippo Parolini,1 Anna Lavinia Bulotta,1 Sonia Battaglia,1 Daniele Alberti1,2 1Department of Pediatric Surgery, “Spedali Civili” Children’s Hospital, 2Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy Abstract: Esophageal atresia remains one of the most challenging congenital anomalies of the newborn. In recent years, because of the advances in prenatal diagnosis, neonatal critical care, and surgical procedures, overall outcomes have improved substantially, including for premature children. Nowadays, most of the research is focused on medium- and long-term morbidity, with particular reference to respiratory and gastroesophageal problems; the high frequency of late sequelae in esophageal atresia warrants regular and multidisciplinary checkups throughout adulthood. Surprisingly, there are few studies on the impact of prenatal diagnosis and there is continuing debate over the prenatal and preoperative management of these complex patients. In this review, we analyze the literature surrounding current knowledge on the management of newborns affected by esophageal atresia, focusing on prenatal management and preoperative assessment. Keywords: prenatal diagnosis, esophageal atresia, tracheoesophageal fistula, ultrasound scan, tracheobronchoscopy

The tracheal collapse affects mainly small breeds, middle-aged and older dogs and the diagnosis is made based on clinical signs and additional exams. The trachealbronchoscopy allows evaluating the trachea diameter and bronchial segments, especially when radiographic and fluoroscopy is not conclusive and still allows the collection of samples for cytology, histopathology and cultures. The objective of this study was evaluate if there is a correlation between bacterial tracheal infection and tracheal inflammation in dogs with tracheal collapse. The sample consisted of 28 dogs, including 12 with collapsing trachea and 16 healthy subjects in the control group. For data collection was used the trachealbronchoscopy, in which was visualized the trachea, collected samples for cytology and bacterial culture. After analyzing the results, we found positive correlation in inflammation and tracheal collapse. There was no correlation between bacterial infection and inflammation in the trachea. With dissimilarity test was observe that the bacterial population of the pharynx was similar to the trachea in dogs of the same group. In this study, therefore, concluded that dogs with collapsing trachea tend to have the inflamed trachea, but it does not have bacterial infection. The composition of the bacteria in the trachea may be due to aspiration of pharynx's contents. [ABSTRACT FROM AUTHOR]

Abstract: Tracheo-oesophageal fistula with oesophageal atresia is common life-threatening congenital malformations with an incidence of 1 in 3500 to 1 in 4500 births. ‘H’ type tracheo-oesophageal fistula is an isolated type with an incidence of 4–5% and least association with congenital anomalies. Its diagnosis is often delayed .We report two cases, one presented as a 3months female child with ‘nasal regurgitation of feeds, recurrent pneumonia and choking on feeding since 15days of life, while the other immediately after birth with classic triad of symptoms. A review of the literature is presented, with a focused discussion of presentation and treatment options. Confirmation of diagnosis was done by compiling clinical presentation, high index of suspicion and rigid tracheobronchoscopy findings. Management involved surgery by right transcervical approach. High index of clinical suspicion and early diagnosis can provide a better prognosis. [Copyright &y& Elsevier]

Introduction: Tracheostomy-related tracheal tear is a serious complication that may follow surgical or percutaneous tracheostomy. Pediatric populations carry a higher risk because of anatomical differences. The aim of this article is to review this condition and to help in its diagnosis and management with the assistance of clinical and radiological findings., Materials and Methods: An English literature review was done using the terms pediatric, tracheostomy, tracheal tear and tracheostomy tube., Result: Two cases reported in the literature met the criteria to be included in the review., Discussion: Tracheostomy-related tracheal tear needs immediate diagnosis as it may lead to life-threatening outcomes, such as pneumothorax, respiratory distress, extensive subcutaneous emphysema and pneumomediastinum. Symptoms and complications of the tear may occur intraoperatively or postoperatively. Gold standard methods for diagnosis include flexible or rigid tracheobronchoscopy, which helps in determining the management plan. The treatment choices for iatrogenic tracheal tears depend on the tear site, size, and extension of the tear and patient's hemodynamic status. Conservative management is sufficient for stable patients with small tears, whereas surgical management is essential for unstable patients and those with large or complicated tears., Conclusion: Tracheostomy-related tracheal tear is a serious rare complication. The pediatric age group carries a higher risk of the condition and its management, either conservative or surgical, depends on airway endoscopy findings and patient's hemodynamic status., Competing Interests: The authors declare no conflict of interest, financial or otherwise., (© 2022 Alenezi et al.)

The article presents a case study on the detection of a Oslerus osleri infection in a free-living maned wolf. Fecal samples were collected and analyzed, in which the presence of a spiral larvae was observed. The characteristics of the larvae was similar with the Filaroididae gamily of the nematode O. osleri. The larvae caused the respiratory tract infection of the wolf.

A 45-year-old Hermann's tortoise (Testudo hermanni boettgeri) was presented for therapy- resistant respiratory tract disease of several months duration. On presentation, the animal showed severe inspiratory distress and produced wheezing sounds on inspiration. Computed tomography and tracheobronchoscopy revealed bilateral bronchial collapse. Histopathology showed cartilaginous lesions comparable to those of tracheobronchomalacia described in dogs and humans. [ABSTRACT FROM AUTHOR]

Background/Purpose: During repair of esophageal atresia with distal tracheo-esophageal fistula, air leakage through the fistula during mechanical ventilation can cause respiratory demise. Methods: From February 2012 until November 2014, all patients with esophageal atresia and distal tracheo-esophageal fistula were subjected to preoperative tracheobronchoscopy. Relatively distal fistulas were cannulated with a Fogarty catheter and blocked by insufflation (video illustration). Relatively proximal distal fistulas were sealed by precise placement of a cuffed ventilation tube. Results: Nine of 12 patients received Fogarty balloon placement. The fistula of the remaining 3 patients were sealed by careful tube placement. No complications related to tracheobronchoscopy or Fogarty placement were noted. All procedures were uneventful. Conclusions: Preoperative tracheobronchoscopy to evaluate the usefulness of Fogarty balloon insertion or correct tube placement for distal tracheo-esophageal fistula is a safe and easy to perform procedure that can avoid complications in type C esophageal atresia repair. [ABSTRACT FROM AUTHOR]

• Bronchomalacia is defined as dynamic collapse of segmental/subsegmental bronchi. • It cannot be diagnosed using thoracic radiography but requires advanced imaging. • Classification should score changes in airway caliber and functional impairment. • Comorbid conditions, including other types of airway collapse, are common. • No known direct treatment to reverse or delay progression of airway collapse exists. Bronchomalacia (BM) is an inconsistently defined term in dogs, impairing understanding of clinical presentation, therapeutic response and prognosis. Herein the authors propose to clarify the definition of canine bronchomalacia (CBM) as regional to diffuse dynamic airway collapse of segmental and/or subsegmental bronchi with associated clinical signs due to airflow limitation. In contrast to tracheal collapse, mainstem bronchial collapse, and in some cases lobar collapse, CBM requires advanced imaging. Common co-morbid conditions (e.g., chronic bronchitis, mitral valve degenerative disease, etc.) should be identified during a comprehensive diagnostic evaluation. Current empiric treatments advocated in absence of clinical trials documenting efficacy in the dog warrant evaluation, as some (e.g., bronchodilators) may have detrimental effects in certain types of airway collapse in humans. There is no direct treatment for CBM, as defined above, but non-specific therapies and targeted treatment of co-morbid disease may improve clinical signs and quality of life. In this manuscript, the authors provide a review of the different types of airway collapse focusing on CBM, reviewing their definition and etiology, proposing a classification scheme, and discussing clinical signs, diagnostic testing, and treatment. Future studies should focus on both improving understanding of the etiology and natural disease progression of CBM and treatment trials. [ABSTRACT FROM AUTHOR]

Exercise-induced pulmonary hemorrhage (EIPH) occurs commonly in horses undergoing strenuous exercise. Reported risk factors include racing in cold temperatures and wearing of bar shoes. In horses with documented moderate to severe EIPH, increasing the interval between races and adopting a negative race pace strategy may reduce the severity of EIPH in subsequent races. EIPH seems to have an impact on performance only when moderate to severe. This occurs in a small number of starters, approximately 6%. EIPH often is erratic in severity from race to race, although across a population it is weakly progressive over increasing race starts., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Abstract: Aim of the Study: This retrospective study was performed to compare the relative incidence of esophageal atresia (EA) with proximal tracheoesophageal fistula (PTEF) at our institution with those reported in literature and to test the hypothesis that our higher relative incidence is caused by the routine use of tracheoscopy. Methods: A total of 204 children with EA were managed at our institution from 1981 to 2012. The type of EA and the diagnostic assessment were noted, and the relative incidence of PTEF was calculated. For patients managed from 1981 to 2003 (Group 1), the PTEF was diagnosed by contrast esophagogram or during surgical repair. For those born after 2004 (Group 2), the final diagnosis was made by routine rigid tracheoscopy performed preoperatively. The relative incidence of PTEF was compared between these two groups and with those reported in 15 selected published large series, encompassing 4197 patients with EA. Main Results: Of 204 patients with EA, 10 had PTEF, with a relative incidence of 4.9%, statistically higher than those reported in reference group (1.14%, P <0.001). The routine employ of tracheoscopy involved a higher relative incidence of PTEF (Group 2=11.11%, Group 1=3.14%, P =0.038). The age of diagnosis of PTEF was 2.8days for children of Group 2 and 4.2days for Group 1 (P =0.038). Conclusion: The presence of the proximal TEF should be always ruled out before surgery. Routine employ of rigid tracheoscopy avoids delay of the diagnosis, improves diagnostic accuracy, and involves a higher relative incidence of proximal fistul. This procedure should be recommended in children undergoing EA repair. [Copyright &y& Elsevier]

Purpose: Our aim is to compare new non-invasive imaging modalities in the evaluation of vascular ring (VR) and pulmonary artery sling (PAS) and to understand the role of bronchoscopy in comparison with them in assessing tracheobronchial tree., Methods: We have retrospectively analyzed the data from 41 patients with a VR or a PAS diagnosed at Bambino Gesù Children's Hospital of Rome, between 2008 and 2012. Age, gender, presenting symptoms, clinical history, comorbidities, imaging modalities used for diagnosis (cardiac magnetic resonance [CMR], computed tomography [CT], tracheobronchoscopy [TB]) and surgical treatment were recorded., Results: The vascular anatomy was completely defined in all patients, whether evaluated by CMR or CT, with a diagnostic accuracy of 100% based on surgical observation. All CT exams were performed without sedation with a mean dose-length product (DLP32 ) of 29 ± 9 and an effective dose of 1.56 ± 0.6 mSv, range 0.5-2.5 mSv. CMR required general anesthesia in all patients but involved no exposure to ionizing radiation. CT performed better than CMR in assessing tracheal stenosis when compared to TB. It detected complete tracheal cartilage rings in 2/3 patients with PAS, besides tracheomalacia and/or bronchomalacia in 54% of patients., Conclusions: Both cross-sectional imaging modalities (CT and CMR) can reliably and accurately diagnose these congenital vascular anomalies. While CT involves exposure to ionizing radiation, it avoids the risks related to anesthesia needed for CMR, and provides a more accurate assessment of tracheobronchial anatomy. TB remains a fundamental tool in tracheomalacia diagnosis in VR symptomatic patients and PAS., (© 2014 Wiley Periodicals, Inc.)

Preoperative tracheobronchoscopy (TBS) in the diagnostic assessment of newborns affected by esophageal atresia (EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included in the diagnostic and therapeutic assessment in many international pediatric surgery settings. Routine preoperative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualization of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fogarty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.