Extrinsic tracheobronchial compression

Abstract

Extrinsic compression of the airway is an uncommon cause of respiratory distress in children. The most significant lesions occur along the thoracic airway. The differential diagnosis includes vascular anomalies and mediastinal masses. Aberrant innominate artery, pulmonary vascular sling, and aortic vascular rings are the usual vascular lesions that cause extrinsic airway compression. Cardiac chamber and pulmonary vascular enlargement are less common causes. Mediastinal masses that compress the airway include inflammatory lymphadenopathy, lymphoma, germ cell tumors, thymus derivatives, neural crest tumors, and bronchogenic cysts. Recent refinements in tracheography, ultrasonography, spiral CT, and magnetic resonance imaging have increased our ability to identify specific causes with acceptable risk and morbidity.