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Diagnostic flexible versus rigid bronchoscopy for the assessment of tracheomalacia in children

Published online by Cambridge University Press:  18 December 2018

J Choi ,
H Dharmarajan ,
J Yu ,
K A Dunsky ,
T J Vece ,
E H Chiou  and
J Ongkasuwan
J Choi*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
H Dharmarajan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
J Yu
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
K A Dunsky
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
T J Vece
Affiliation:
Department of Pediatrics – Pulmonology, Baylor College of Medicine, Houston, Texas, USA
E H Chiou
Affiliation:
Department of Pediatrics – Gastroenterology, Baylor College of Medicine, Houston, Texas, USA
J Ongkasuwan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
*
Author for correspondence: Dr Jonathan Choi, Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, One Baylor Plaza Suite NA-102, Houston, TX 77030, USA E-mail: choi.s.jonathan@gmail.com Fax: +1 713 798 3403
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Abstract

Objective

This project compares the degree of tracheal collapse determined by rigid and flexible bronchoscopy in paediatric patients with tracheomalacia.

Methods

A total of nine patients with tracheomalacia underwent both rigid and flexible video bronchoscopy. All patients were breathing spontaneously. Cross-sectional images of the airway were processed using the ImageJ program and analysed via colour histogram mode technique in order to delineate the luminal area. Paired t-tests (conducted using Stata software version 13.0) quantified differences between rigid and flexible bronchoscopes regarding the ratios of luminal pixels at maximum airway collapse to expansion. Correlation between both techniques in terms of airway collapse to expansion ratios was determined by calculating the Pearson correlation coefficient (R).

Results

The difference in ratios of maximum collapse to expansion between rigid and flexible bronchoscopy was not statistically significant (p = 0.4656) and was positively correlated (R = 0.523).

Conclusion

The ratios suggest that rigid and flexible bronchoscopy are equally efficacious in assessing tracheomalacia severity, and may be used interchangeably in a clinical setting.

Keywords

TracheomalaciaBronchoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 12 , December 2018 , pp. 1083 - 1087
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr J Choi takes responsibility for the integrity of the content of the paper

Presented as a poster at the Society for Ear, Nose and Throat Advances in Children (‘SENTAC’), 2–4 December 2016, Orlando, Florida, USA.

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