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Prevalence and characteristics of tracheal cobblestoning in children
Author(s) -
Dave Mital H.,
Gerber Andreas,
Bailey Martin,
Gysin Claudine,
Hoeve Hans,
Hammer Juerg,
Nicolai Thomas,
Weiss Markus
Publication year - 2015
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23142
Subject(s) - medicine , gerd , concomitant , tracheal intubation , population , exact test , chi square test , pulmonary aspiration , pediatrics , airway , reflux , surgery , intubation , disease , statistics , environmental health , mathematics
Summary Background Tracheal follicular pattern or so‐called tracheal cobblestoning is a poorly described entity in the literature and is depicted as a nodular or lumpy appearance of the tracheal wall mucosa suggesting tracheal irritation from factors like gastro‐esophageal reflux (GERD) or pulmonary infection. The aim of the present study was to investigate the prevalence and characteristics of tracheal cobblestones in a large pediatric population. Methods A large database of rigid tracheoscopies recorded in children (0–6 years of age) undergoing general anesthesia with planned tracheal intubation for elective surgical procedures was retrospectively analyzed. Tracheoscopy records were reviewed by five pediatric airway experts (authors 3–7). Data were compared using the Mann–Whitney test, chi‐square or Fisher exact test as appropriate ( P < 0.05). Results A total of 971 rigid tracheoscopy records were analyzed. The median age of the patients was 3.3 years (range 0.4–6.0 yrs). Cobblestones were present in 377 out of 971 patients (38.8%) with a male to female prevalence of 254 (40.6%)/123 (35.5%). None of the children under four months of age showed the presence of cobblestones. The prevalence of cobblestones was significantly less in patients under 3 years of age compared to over 3 years ( P < 0.01). There was no association between prevalence of cobblestones and GERD, current or recent respiratory infection or concomitant enlarged tonsils. Conclusion The prevalence of tracheal cobblestones in otherwise healthy children is high and is not associated with GERD or respiratory infection. The gender and age related differences are novel interesting findings that require further investigations. Pediatr Pulmonol. 2015; 50:995–999. © 2014 Wiley Periodicals, Inc.