Congenital tracheobronchial branching anomalies – types and clinical significance.
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Human Anatomy Research Group, Medical University, Lublin, Poland
1st Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland
Department of Correct, Clinical and Imaging Anatomy, Medical University, Lublin, Poland
Corresponding author
Julia Lewtak   

Human Anatomy Research Group, Medical University of Lublin, Lublin, Poland
Introduction and objective:
Objective.The tracheobronchial tree consists of the pathways through which air reaches the pulmonary alveoli. Anomalies in the tracheobronchial tree can be both congenital and acquired. Congenital anomalies include tracheal bronchus, accessory cardiac bronchus, lung aplasia, hypoplasia, or agenesis. The aim of this review is to summarise knowledge about the most common congenital anomalies in the tracheobronchial tree, and associated symptoms.

Review methods:
The review was created based on 19 papers found in PubMed and PubMedCentral databases after searching for: ’tracheobronchial branches abnormality’, ‘tracheal bronchus’, and ‘accessory cardiac bronchus’, published between 2001–2023.

Brief description of the state of knowledge:
Accessory cardiac bronchus (ACB) and tracheal bronchus (TB) are the 2 most common congenital anomalies of the tracheobronchial tree. The incidence of ACB ranges from 0.07% – 0.5%, and TB between 0.9% – 3% There are 3 types of ACB, with type I being the most common. TB is most frequently detected on the right side. Both anomalies are often asymptomatic; however, diagnosing them may be crucial in cases of recurrent symptoms of unknown origin, such as cough, haemoptysis or recurrent pneumonia. They may also contribute to complications in surgical procedures conducted on the respiratory tract or within the chest cavity.

Understanding the occurrence of anatomical anomalies in the branching of the tracheobronchial tree can facilitate the diagnosis of atypical respiratory symptoms and clarify the cause of procedural failures, such as bronchoscopy, intubation or thoracic surgery.

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