Prevalence and Morphometric Study of Bronchial Anatomical Variations in Cadaveric and Bronchoscopic Samples
Keywords:
Bronchial Anatomy, Anatomical Variations, Bronchoscopy, Tracheobronchial TreeAbstract
Background: Advancements in knowledge regarding interventional pulmonology and thoracic surgery have pointed out the need for a precise understanding of bronchial anatomy and its variations. Despite different researches documenting bronchial segmentation patterns, data on variation prevalence and morphometric measurements remain limited, particularly in diverse clinical populations. Objective: To determine the prevalence of anatomical variations in bronchial segmentation across cadaveric and bronchoscopic samples. Methodology: An observational study was conducted using two cohorts, i.e., a cadaveric sample of 27 pairs of lungs (15 male, 12 female) dissected and 70 bronchoscopic samples (45 male, 25 female) documented during a real-time videobronchoscopy procedure. Strict inclusion criteria applied for the study, including adult donors (>18 years) without thoracic surgery or significant pulmonary pathology and preserved tracheobronchial anatomy. All data were included in SPSS for statistical analysis. Chi-square tests were used for variation prevalence and descriptive statistics for bronchial lengths by using SPSS. Results: Of the 97 bronchial samples analyzed, 61.9% showed one or more anatomical variations, while 38.1% exhibited normal anatomy. The most frequent variation was bifurcation in the right upper lobe (15.5%), followed by subsuperior bronchus in the right lower lobe (20.6%). Lingular trifurcation in the left upper lobe was significantly more common in cadaveric samples (p = 0.038). Overall, cadaveric dissections revealed rarer anomalies more frequently than bronchoscopic evaluations. Conclusion: Bronchial anatomical variations are highly prevalent, with the RLL and LUL being the most variable regions. The morphometric data provide critical benchmarks for surgical and bronchoscopic interventions. These findings advocate for preoperative imaging to anticipate variations, reducing procedural risks. Larger multi-center studies are recommended to validate these trends.References
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