Abstract:
PURPOSE:To document the possible association of segmental tracheomalacia in the thoracic inlet with the combination of a large thymus and normal innominate artery. MATERIALS AND METHODS:Eight infants with symptoms of innominate artery compression of the trachea were studied. The diagnostic approach included observation of posterior tracheal displacement and focal tracheal collapse at fluoroscopy, ablation of the right radial pulse by rigid endoscopic pressure, and compression of the anterior tracheal wall by the innominate artery at magnetic resonance imaging. RESULTS:Six patients had relief of symptoms with either thymectomy and innominate artery reimplantation (n = 4) or subtotal thymectomy and innominate artery suspension (n = 2). The ratio of the sagittal diameter of the thymus to the sagittal diameter of the thoracic inlet was significantly (P < .0009) higher in the symptomatic patients (0.58 +/- 0.03) than in age-matched control subjects (0.35 +/- 0.08). CONCLUSION:Crowding of the thoracic inlet by cervical herniation of an enlarged but normal thymus may contribute to the development of tracheomalacia and the symptoms of innominate artery compression.
journal_name
Radiologyjournal_title
Radiologyauthors
Mandell GA,McNicholas KW,Padman R,Harcke HTdoi
10.1148/radiology.190.1.8259390subject
Has Abstractpub_date
1994-01-01 00:00:00pages
131-5issue
1eissn
0033-8419issn
1527-1315journal_volume
190pub_type
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