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Aktaş F, Aktaş T. Volume Measurement in the Diagnosis of Mounier Kuhn Syndrome and an Unknown Accompanying Pathology: Pulmonary Artery Enlargement. Curr Med Imaging 2020; 15:796-801. [PMID: 32008547 DOI: 10.2174/1573405615666190220110628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/21/2018] [Accepted: 01/22/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mounier Kuhn Syndrome (MKS) is a rare congenital anomaly characterized by abnormal dilatation of the trachea and main bronchi. The aim of this study is to discuss tracheal volume measurement in MKS, and the pathologies accompanying MKS, especially pulmonary artery enlargement. MATERIALS AND METHODS 38 patients, 18 of whom were diagnosed with MKS and 20 as control group, were included in the study. Trachea volume and pulmonary artery diameter were measured through thorax-computed tomography (CT) images of the patients. Accompanying pathologies were recorded. RESULTS In the measurements done through the CT scans, the trachea volume was found to be 25.45 cm3 in the control group and 44.17 cm3 in the patient group. The most frequent accompanying pathologies were tracheal diverticulum, bronchiectasis and pulmonary artery enlargement. CONCLUSION In patients with MKS, there is a significant difference in volume calculation as in trachea diameter. Though bronchiectasis and tracheal diverticulum are known as pathologies most frequently accompanying MKS, to the knowledge of the researchers, pulmonary artery enlargement due to the increase in pulmonary truncus diameter was first emphasized in this article.
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Affiliation(s)
- Fatma Aktaş
- Radiology Department, School of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Turan Aktaş
- Pulmonary Diseases Department, VERSA Hospital, Nevsehir, Turkey
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Tracheobronchomegaly as a Cause of Bronchiectasis in an Adult. Case Rep Pulmonol 2016; 2016:5049406. [PMID: 27022496 PMCID: PMC4789050 DOI: 10.1155/2016/5049406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/19/2016] [Accepted: 01/26/2016] [Indexed: 11/17/2022] Open
Abstract
Mounier-Kuhn syndrome (MKS) is a rare congenital anomaly characterized by dilated trachea and main bronchi due to atrophy of the elastic fibers and smooth muscle cells of the trachea and major airways. Patients of MKS can have varied presentation. The diagnosis is established radiologically and bronchoscopically. There is no specific treatment for MKS. We present an adult man with MKS who presented with recurrent respiratory tract infection. The diagnosis was confirmed by imaging study and fiberoptic bronchoscopy.
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A Forty-Six-Year-Old Man With Tracheomegaly and Bronchiectasis. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2012. [DOI: 10.5812/archcid.14644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Odell DD, Shah A, Gangadharan SP, Majid A, Michaud G, Herth F, Ernst A. Airway stenting and tracheobronchoplasty improve respiratory symptoms in Mounier-Kuhn syndrome. Chest 2011; 140:867-873. [PMID: 21493699 DOI: 10.1378/chest.10-2010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Mounier-Kuhn syndrome (MKS) is a condition characterized by tracheobronchomegaly resulting from the loss or atrophy of musculoelastic fibers within the airway wall. Concomitant tracheobronchomalacia is seen in most patients with MKS, often leading to significant respiratory compromise due to bronchiectasis, increased dead space, and impaired secretion clearance. METHODS We report a series of 12 patients with MKS and tracheobronchomalacia who were evaluated at our institution for significant respiratory problems. Stent trials were conducted in 10 patients, with seven proceeding to operative tracheobronchoplasty (TBP) and one continuing with long-term stent placement. One patient underwent TBP without prior stent placement. Of the remaining three patients, two had no improvement with trials of stent placement, and a stent could not be placed in the third because of a large tracheal diameter. RESULTS Compared with baseline values, clinically significant improvements in health-related quality-of-life measures and pulmonary function testing were seen in patients who underwent central airway stabilization (n = 9). Complications of both stent placement and TBP were generally mild. However, one death was reported in the surgical group secondary to an exacerbation of preexisting interstitial pneumonia. CONCLUSIONS An aggressive approach that targets central airway stabilization may improve outcomes for patients with MKS. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT00550602; URL: www.clinicaltrials.gov.
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Affiliation(s)
- David D Odell
- Division of Thoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Archan Shah
- Division of Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Sidhu P Gangadharan
- Division of Thoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Division of Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Adnan Majid
- Division of Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Felix Herth
- Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - Armin Ernst
- Pulmonary, Critical Care and Sleep Medicine, St. Elizabeth's Medical Center, Boston, MA.
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Braham W, Daboussi S, Darouaz S, Ben Salem H, Boudawara N, Knani J. [An unusual association: tracheobronchomegaly with a normal pulmonary function test]. REVUE DE PNEUMOLOGIE CLINIQUE 2010; 66:363-366. [PMID: 21167446 DOI: 10.1016/j.pneumo.2009.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 10/27/2009] [Accepted: 10/28/2009] [Indexed: 05/30/2023]
Abstract
Tracheobronchomegaly is a rare condition characterised by marked dilation of the trachea and the main bronchi. The clinical presentation of this disease is nonspecific and the diagnosis is based on the radiological features, especially computed tomography of chest. Pulmonary function tests are often abnormal showing airflow limitation with increased residual volume. The authors report a rare case of a 31-year-old man presenting tracheobronchomegaly is normal pulmonary function test.
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Affiliation(s)
- W Braham
- Service de pneumologie et d'allergologie, CHU Tahar Sfar, 5111 Hiboun, Mahdia, Tunisie.
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Mounier-Kuhn syndrome: report of 8 cases of tracheobronchomegaly with associated complications. South Med J 2008; 101:83-7. [PMID: 18176298 DOI: 10.1097/smj.0b013e31815d4259] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mounier-Kuhn syndrome is a rare congenital abnormality characterized by atrophy or absence of elastic fibers and thinning of smooth muscle layer in the trachea and main bronchi. These airways are thus flaccid and markedly dilated on inspiration and collapsed on expiration. First- to fourth-order bronchi are affected. There is an increase in dead space, tidal volume and diminished clearing of secretions. The usual presentation is recurrent respiratory tract infections with a broad spectrum of functional impairment ranging from minimal disease with preservation of lung function to severe disease in the form of bronchiectasis, emphysema and pulmonary fibrosis, ultimately culminating in respiratory failure and death. A congenital connective tissue weakness, in combination with inhalation of irritants like cigarette smoke and air pollution, are raised as possible factors in the development of this syndrome. Eight cases of tracheobronchomegaly with its associated complications are reported. Computed tomography scan of the chest was used for the diagnosis of tracheobronchomegaly. Treatment is mainly supportive with chest physiotherapy and antibiotics; however, there are a few reported cases where insertion of a tracheal stent resulted in some success.
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Ghanei M, Peyman M, Aslani J, Zamel N. Mounier-Kuhn syndrome: a rare cause of severe bronchial dilatation with normal pulmonary function test: a case report. Respir Med 2007; 101:1836-9. [PMID: 17428651 DOI: 10.1016/j.rmed.2007.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 02/09/2007] [Indexed: 10/23/2022]
Abstract
Tracheobronchomegaly (TBM) (Mounier-Kuhn syndrome) is dilatation of the trachea and major bronchi because of atrophy or absence of elastic fibers and smooth muscle cells. We present a case of TBM with normal pulmonary function test (PFT). The patient was a 37-year-old man with increasing productive cough and without fever, wheezes, chest pain, weight loss or any respiratory disease. Chest helical computed tomography (CT) scan showed tracheomegaly with transversal diameters of the trachea of 44mm. CT scan showed collapse of the trachea. Few large diverticular out-pouching and openings in the trachea was seen in bronchoscopy. PFT results were normal. PFT in large airway disorders may be normal while abnormalities may indicate underlying small airway disorder. An underlying small airway disorders is responsible for abnormal reports in PFT of these patients. We may need to re-evaluate the role of PFT within follow-up of patients with large airway disorder.
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Affiliation(s)
- Mostafa Ghanei
- Pulmonologist, Baqiyatallah University of Medical Sciences, Mollasadra Street, Tehran, Iran.
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Ali M, Ozir O, Ashame E, Russi T. A 62-YEAR-OLD FEMALE WITH RECURRENT RESPIRATORY INFECTIONS. Chest 2006. [DOI: 10.1378/chest.130.4_meetingabstracts.308s-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Shah SS, Karnak D, Mason D, Murthy S, Pettersson G, Budev M, Mehta AC. Pulmonary transplantation in Mounier-Kuhn syndrome: a case report. J Thorac Cardiovasc Surg 2006; 131:757-8. [PMID: 16515945 DOI: 10.1016/j.jtcvs.2005.11.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2005] [Revised: 11/23/2005] [Accepted: 11/30/2005] [Indexed: 11/19/2022]
Affiliation(s)
- Sonia S Shah
- Pulmonary Diseases and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Joo KR, Oak JH, Lee SE, Jang ST, Kim SK, Lee SH, Song JS, Park SH, Moon HS, Lee BY, Kim HS. A Case of Tracheobronchomegaly with Pneumonia. Tuberc Respir Dis (Seoul) 2006. [DOI: 10.4046/trd.2006.61.4.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kyu Re Joo
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Ju Hyun Oak
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Sung Eun Lee
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Suk Tae Jang
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Sung Kyoung Kim
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Sang Haak Lee
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jeong Sup Song
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Sung Hak Park
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Hwa Sik Moon
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Bae Young Lee
- Department of Radiology, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Hyeon Sook Kim
- Department of Radiology, The Catholic University of Korea, College of Medicine, Seoul, Korea
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Adani GL, Baccarani J, Lorenzin D, Benzoni E, Montanardo D, Tulissi P, Groppuzzo M, Risaliti A, Bresadola F. Renal Transplantation in a Patient Affected by Mounier-Kuhn Syndrome. Transplant Proc 2005; 37:4215-7. [PMID: 16387081 DOI: 10.1016/j.transproceed.2005.11.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Indexed: 11/21/2022]
Abstract
Tracheobronchomegaly, also called Mounier-Kuhn syndrome, consists in dilatation of the trachea and major bronchi because of atrophy or absence of their elastic fibers and smooth muscle cells. Standard chest radiography often does not permit diagnosis because only lateral imaging, obtained with X-rays or chest CT scan, shows the true degree of tracheal dilatation. Surgery has no role in tracheomegaly, except for the complications of tracheal stenosis or pneumothorax. The present work reports cadaveric renal transplantation in a 43-year-old woman affected by end-stage renal disease and suffering from congenital tracheobronchomegaly diagnosed during the first decade of life. No surgical or anesthetic problems were encountered during the immediate perioperative period. The patient did not require pulmonary physiotherapy. Antibiotic prophylaxis was given for 10 days. No pulmonary infection developed, and the patient was discharged from the hospital asymptomatic with normal renal function at 25 days after the transplant. Four months later, the patient experienced bronchitis with cough and fever. Antibiotic therapy was performed with totally resolution of symptoms. At 8 months of follow-up after kidney transplantation, the patient is asymptomatic with normal renal function.
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Affiliation(s)
- G L Adani
- Department of Surgery and Transplantation, University School of Medicine, Udine, Italy
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Lazzarini-de-Oliveira LC, Costa de Barros Franco CA, Gomes de Salles CL, de Oliveira AC. A 38-year-old man with tracheomegaly, tracheal diverticulosis, and bronchiectasis. Chest 2001; 120:1018-20. [PMID: 11555541 DOI: 10.1378/chest.120.3.1018] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- L C Lazzarini-de-Oliveira
- Pulmonary Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil.
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