Akdeniz Aysun, Kara Erdoğan
Department of Pulmonology, Avicenna Hospital, İstanbul, Turkey.
Department of Autopsy, Council of Forensic Medicine, Ministry of Justice, İstanbul, Turkey.
Turk Thorac J. 2021 Mar;22(2):124-129. doi: 10.5152/TurkThoracJ.2021.18111. Epub 2021 Mar 1.
There are various anatomic variations in the tracheobronchial system. The frequency in studies with bronchoscopy was contradictory. This study aimed to investigate the tracheobronchial tree of the deceased patients with anatomical dissection.
We made anatomical dissections on 204 cases in the Council of Forensic Medicine, Ministry of Justice. The deceased patients who were older than 12 years of age and of Turkish origin were included in this study consecutively.
Of the 204 cases, 161 (78.9%) were males and 43 (21.1%) were females. The mean age was 44.15±19.23 years. Anatomical variations were found to be present in 200 cases (98% of total). The highest degree of variation of the right upper lobe was noted to be 16.6% (34/204). An anomalous arrangement (with three segments or different placement) of the middle lobe was noted in 16.1% of cases. For the basal lower lobe, b8+(b9+b10) pattern and basal orifice with four segments were noted to be the most frequent anatomical variant in the right and left lungs, respectively. The most frequent tracheobronchial variations were as follows: apical basal lobe with two subsegments in the right and left (39.7%), left lower lobe basal orifice with four segments (34.8%), left upper lobe with three segments (25.5%), and right lower lobe basal orifice with three main segmental bronchi (21.1%).
The tracheobronchial tree exhibits highly individualistic features. The knowledge of the frequency of different variations obtained in different studies and normal anatomic variants in return makes doing therapeutic or diagnostic interventions easier and more accurate.
气管支气管系统存在多种解剖变异。支气管镜检查研究中的发生率相互矛盾。本研究旨在通过解剖来调查已故患者的气管支气管树。
我们对司法部法医委员会的204例病例进行了解剖。本研究连续纳入了年龄大于12岁且为土耳其裔的已故患者。
204例病例中,男性161例(78.9%),女性43例(21.1%)。平均年龄为44.15±19.23岁。发现200例(占总数的98%)存在解剖变异。右上叶变异程度最高为16.6%(34/204)。中叶异常排列(有三个节段或不同位置)在16.1%的病例中被发现。对于下叶基底段,右肺中最常见的解剖变异模式是b8+(b9+b10)型,左肺中最常见的是有四个节段的基底孔。最常见的气管支气管变异如下:左右肺均有两个亚段的尖基底叶(39.7%)、有四个节段的左下叶基底孔(34.8%)、有三个节段的左上叶(25.5%)以及有三个主段支气管的右下叶基底孔(21.1%)。
气管支气管树表现出高度个体化的特征。了解不同研究中不同变异的发生率以及正常解剖变异,反过来会使治疗或诊断干预更容易且更准确。