Background: Most data about the trachea are collected during deep inspiration breath holding (DIBH) using multi-detector computed tomography (MDCT). Images of the physiological changes in the central airway are lacking. Objective: The aim of this study was to explore the physiological changes in the central airway on MDCT during DIBH and deep expiration breath holding (DEBH). Method: The data from 62 patients (38 men and 24 women) who underwent enhanced computed tomography in our hospital were collected. Patients were grouped according to sex and age (18–45, 46–60, and >61 years). Anteroposterior diameter (APD) and transverse diameter (TD) at 3 levels (cricoid, intrathoracic inlet, and 2 cm above the carina), tracheal length, bronchial length, and subcarina angle (SCA) were measured. Results: The average length of the trachea from the cricoid cartilage to the carina was 103.91 ± 10.37 mm at DEBH and 108.63 ± 11.31 mm at DIBH (p < 0.001). The APD of the trachea at the level of the cricoid, intrathoracic inlet, and 2 cm above the carina showed no differences between DEBH and DIBH. The TD of the trachea at the level of the cricoid, intrathoracic inlet, and 2 cm above the carina showed no differences between DEBH and DIBH. The average length of the right main bronchus during DEBH and DIBH was measured as 13.21 ± 3.60 and 13.24 ± 3.49 mm, respectively (p = 0.956). The average length of the left main bronchus at DEBH and DIBH was measured as 44.19 ± 5.50 and 44.27 ± 5.11 mm, respectively (p = 0.929). The average SCA was 81.74 ± 14.56 at DIBH, while it was 80.53 ± 14.38 at DEBH. The change in SCA between DIBH and DEBH showed no significant difference (p = 0.642). Conclusions: The APD at the level of the intrathoracic inlet is larger than that at the cricoid and 2 cm above the carina, while the TD is the opposite. These findings about the trachea and bronchus in our study may contribute to bronchoscopy examinations, tube applications, stent design, and stenting.

1.
Safshekan
F
,
Tafazzoli-Shadpour
M
,
Abdouss
M
,
Behgam Shadmehr
M
,
Ghorbani
F
.
Investigation of the Mechanical Properties of the Human Tracheal Cartilage
.
Tanaffos
.
2017
;
16
(
2
):
107
14
.
[PubMed]
1735-0344
2.
Safshekan
F
,
Tafazzoli-Shadpour
M
,
Abdouss
M
,
Shadmehr
MB
.
Mechanical Characterization and Constitutive Modeling of Human Trachea: Age and Gender Dependency
.
Materials (Basel)
.
2016
Jun
;
9
(
6
):
E456
.
[PubMed]
1996-1944
3.
Chae
Y
,
Protsenko
D
,
Holden
PK
,
Chlebicki
C
,
Wong
BJ
.
Thermoforming of tracheal cartilage: viability, shape change, and mechanical behavior
.
Lasers Surg Med
.
2008
Oct
;
40
(
8
):
550
61
.
[PubMed]
0196-8092
4.
Laroia
AT
,
Thompson
BH
,
Laroia
ST
,
van Beek
E
 Jr
.
Modern imaging of the tracheo-bronchial tree
.
World J Radiol
.
2010
Jul
;
2
(
7
):
237
48
.
[PubMed]
1949-8470
5.
Shepard
JO
,
Flores
EJ
,
Abbott
GF
.
Imaging of the trachea
.
Ann Cardiothorac Surg
.
2018
Mar
;
7
(
2
):
197
209
.
[PubMed]
2225-319X
6.
Herek
D
,
Herek
O
,
Ufuk
F
.
Tracheobronchial Angle Measurements in Children: An Anthropometric Retrospective Study With Multislice Computed Tomography
.
Clin Exp Otorhinolaryngol
.
2017
Jun
;
10
(
2
):
188
92
.
[PubMed]
1976-8710
7.
M U
.
Y P, I.I U, A.S. K, N.U D. Age and gender related changes in bronchial tree: a morphometric study with multidedector CT
.
Eur Rev Med Pharmacol Sci
.
2016
;
•••
:
20
.1128-3602
8.
Montaudon
M
,
Desbarats
P
,
Berger
P
,
de Dietrich
G
,
Marthan
R
,
Laurent
F
.
Assessment of bronchial wall thickness and lumen diameter in human adults using multi-detector computed tomography: comparison with theoretical models
.
J Anat
.
2007
Nov
;
211
(
5
):
579
88
.
[PubMed]
0021-8782
9.
Zanella
A
,
Cressoni
M
,
Ferlicca
D
,
Chiurazzi
C
,
Epp
M
,
Rovati
C
, et al.
Spatial orientation and mechanical properties of the human trachea: a computed tomography study
.
Respir Care
.
2015
Apr
;
60
(
4
):
561
6
.
[PubMed]
0020-1324
10.
Usuba
A
,
Yamashiro
T
,
Handa
H
,
Matsuoka
S
,
Yamano
Y
,
Mineshita
M
, et al.
Quantitative Computed Tomography Measurement of Tracheal Cross-Sectional Areas in Relapsing Polychondritis: Correlations with Spirometric Values
.
Respiration
.
2015
;
90
(
6
):
468
73
.
[PubMed]
1423-0356
11.
Nawshin
N
,
Foysal
AA
,
Epsi
EZ
,
Ahmed
Z
.
Gross Morphological Variation of Luminal Diameter of the Trachea in Different Age and Sex Groups of Bangladeshi Cadavers
.
Journal of Enam Medical College.
2017
;
7
(
3
):
146
50
.
12.
OLIVIER P
.
HAYON-SONSINO D, CONVARD J, LALOË P, FISCHLER M. Measurement of left mainstem bronchus using multiplane CT Reconstructions and relationship between patient characteristics or tracheal diameters and left bronchial diameters
.
Chest
.
2006
;
•••
:
130
.0012-3692
13.
Kamel
KS
,
Lau
G
,
Stringer
MD
.
In vivo and in vitro morphometry of the human trachea
.
Clin Anat
.
2009
Jul
;
22
(
5
):
571
9
.
[PubMed]
0897-3806
14.
Marchese
R
,
Poidomani
G
,
Paglino
G
,
Crimi
C
,
Lo Nigro
C
,
Argano
V
.
Fully covered self-expandable metal stent in tracheobronchial disorders: clinical experience
.
Respiration
.
2015
;
89
(
1
):
49
56
.
[PubMed]
1423-0356
15.
Holden
VK
,
Ospina-Delgado
D
,
Chee
A
,
Parikh
MS
,
Carreiro
MM
,
Alape Moya
D
, et al.
Safety and Efficacy of the Tracheobronchial Bonastent: A Single-Center Case Series
.
Respiration
.
2020
;
99
(
4
):
353
9
.
[PubMed]
1423-0356
16.
Gil
D
,
Ortiz
RM
,
Sánchez
C
,
Rosell
A
;
SENSA team
.
Objective Endoscopic Measurements of Central Airway Stenosis: A Pilot Study
.
Respiration
.
2018
;
95
(
1
):
63
9
.
[PubMed]
1423-0356
17.
Lee
HJ
,
Labaki
W
,
Yu
DH
,
Salwen
B
,
Gilbert
C
,
Schneider
AL
, et al.
Airway stent complications: the role of follow-up bronchoscopy as a surveillance method
.
J Thorac Dis
.
2017
Nov
;
9
(
11
):
4651
9
.
[PubMed]
2072-1439
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.