Carina of trachea morphology and location variants: bronchoscopy data

Abstract

Background. The study is devoted to the carina of trachea morphology and location variants and the specific aspects of their clinical significance. Materials and methods. The results of 21792 primary bronchoscopies (100.00%) from 2006 to 2022 were analyzed. Carina of trachea morphology and location variants were studied. The potential relationship with the foreign bodies’ localization in the tracheobronchial tree as well as the intubation of the right main bronchus was evaluated to assess the clinical significance of the location variants. For this, the chi-square independence test was used. Results. In most cases, a membranous variant of the carina was detected – 13313 observations (61.090%); the second place is occupied by the cartilaginous variant – 7128 observations (32.710%); the mixed variant of the carina was found in 1351 observations (6.200%). Most often, carina had the left paramedian position - 11837 observations (54.318%); the median position was found in 8975 observations (41.185%); the right paramedian position was noted in 980 cases (4.497%). The dependence between foreign body location in the tracheobronchial tree and the carina position was not revealed. The identified relationship between the carina location and intubation of the right main bronchus (as a tracheal intubation complication) is statistically significant. Conclusions. The most frequent morphological carina structure variant is the membranous one, and the most frequent position of the carina is the left paramedian. Information about the carina location should be reflected in the protocol of endoscopy.

Keywords

• karina tracheal bifurcation
• cartilaginous variant
• membranous variant
• middle position
• paramedian position