Clinical Features Of Airway Dysplasia In Children: A Retrospective Analysis Of 172

ObjectiveTo investigate the clinical features of airway dysplasia in children.MethodTotally, 172 children diagnosed with airway dysplasia using fiexible bronchofiberscope in Children’s Hospital of Chongqing Medical University from June l, 2014 to May 31, 2015 were included in this retrospective study.Result1.There were 138 cases of single airway sysplasia in our study. 50 cases of bronchomalacia; 45 cases of airway stenosis(2 cases of tracheal stenosis, 42 cases of bronchial stenosis, 1 case of tracheobronchial stenosis); 28 cases of airway opening anomaly(12 cases of tracheal bronchus, 16 cases of other abnormal opening); 7 cases of laryngeal cartilage dysplasia; 6 cases of airway diverticulum(1 case of tracheal diverticulum, 5 cases of bronchial diverticulum); 2 cases of bronchial transposition.There were 34 cases of mixed dysplasia. 5 cases of airway malacia combine stenosis, 3 cases of airway malacia combine opening anomaly, 1 case of airway malacia combine diverticulum, 16 cases of airway opening anomaly combine stenosis, 2 cases of airway opening anomaly combine laryngeal cartilage dysplasia, 1 case of airway opening anomaly combine ridging bronchus, 3 cases of airway stenosis combine laryngeal cartilage dysplasia, 2 cases of airway stenosis combine malacia and opening anomaly. 1 case of airway stenosis combine opening anomaly and ridging bronchus.The location of bronchomalacia include the left lung(n=3), the right lung(n=24) and both of them(n=23). The location of bronchial stenosis include the left lung(n=13), the right lung(n=25) and both of them(n=7). The location of airway opening anomaly include the left lung(n=2): both of them are other abnormal opening; the right lung(n=25): 12 cases of tracheal bronchus, 13 cases of other abnormal opening. The location of bronchial diverticulum include the right lung(n=5).The degree of bronchomalacia were mild(n=17), moderate(n=30) and severe(n=3).2. In our study, there were premature(n=20) and term infant(n=152). The birth weight include underweight(n=23), normal weight(n=142) and over weight(n=7).3. Within 1 year old children, there were 41 cases of bronchomalacia, 20 cases of airway stenosis and 21 cases of mixed dysplasia. There were 9 cases of bronchomalacia, 13 cases of airway stenosis in children aged between 1 and 3. The children who were over 3 years old include 12 cases of airway stenosis,14 cases of airway opening anomaly and 6 cases of mixed dysplasia.In different age groups, statistical difference was noticed in the constituent ratio of bronchomalacia. No statistical difference was noticed in the constituent ratio of airway stenosis. Statistical difference was noticed in the constituent ratio of airway opening anomaly.4. Within 1 year old children, there were 90 cases manifest cough and 48 cases manifest wheeze, the pulmonary signs were moist rale(n=81) and wheezing rale(n=71). In children aged between 1 and 3, there were 37 cases manifest cough and 26 cases manifest wheeze, the pulmonary signs were moist rale(n=37) and wheezing rale(n=26). The children who were over 3 years old, there were 35 cases manifest cough, 10 cases manifest wheeze and 14 cases manifest fever, the pulmonary signs were moist rale(n=18) and wheezing rale(n=36).In different age groups, no statistical difference was noticed in the constituent ratio of cough.5. Within the children who had bronchomalacia, the manifestations were cough(n=48) and wheeze(n=47). The manifestations of children who had airway stenosis were cough(n=43) and wheeze(n=25). The manifestations of children who had airway opening anomaly were cough(n=27) and wheeze(n=13). The manifestations of children who had laryngeal cartilage dysplasia were cough(n=6), wheeze(n=4) and hoarseness(n=1). The manifestations of children who had airway diverticulum were cough(n=6), wheeze(n=1) and anhelation(n=1). The manifestations of children who had bronchial transposition were cough(n=2) and wheeze(n=2).In different type groups of airway dysplasia, no statistical difference was noticed in the constituent ratio of cough.6. The airway remodeling results of bronchomalacia were airway stenosis(n=13) and normal airway(n=37). The airway remodeling results of airway stenosis were confirmed(n=22) and normal airway(n=23). The airway remodeling results of airway opening anomaly were confirmed(n=8), airway stenosis(n=5) and normal airway(n=15). The airway remodeling results of airway diverticulum were confirmed(n=2), airway stenosis(n=1) and normal airway(n=3). The airway remodeling results of bronchial transposition were normal airway(n=2).Conclusion1. Airway dysplasia has been frequently noticed in children aged below 1years old. Most of them are term infant and have a normal birth weight.2. The clinical manifestation is lack of specificity, each type of airway dysplasia is not easy to distinguish.3. Bronchomalacia, airway stenosis(especially bronchial stenosis), airway opening anomaly and laryngeal cartilage dysplasia are frequently noticed in airway dysplasia. Airway diverticulum, bronchial transposition and ridging bronchus are rare.4. Airway remodeling can help to diagnose airway dysplasia, especially for airway diverticulum and stenosis, but it cannot distinguish airway stenosis and malacia.