The Experts below are selected from a list of 1443 Experts worldwide ranked by ideXlab platform
Maxime Sauvage - One of the best experts on this subject based on the ideXlab platform.
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Respiratory Conditions Associated with Tracheobronchomegaly (Mounier-Kuhn Syndrome): A Study of Seventeen Cases
Respiration, 2016Co-Authors: Pierre Schmitt, Hervé Dutau, Levent Dalar, Stéphane Jouneau, Bénédicte Toublanc, Juliette Camuset, Gérard Chatte, Laurent Cellerin, Stéphane Sanchez, Maxime SauvageAbstract:Background: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by enlargement of the trachea and main bronchi and associated with recurrent respiratory tract infections. Objective: This multicenter, retrospective study was carried out to describe respiratory conditions associated with tracheobronchomegaly. Methods: Nine institutions involved in the ‘Groupe d'Endoscopie de Langue Française' (GELF) participated in this study. A standard form was used to record patient characteristics, treatments and follow-up from medical charts. Results: Seventeen patients, 53% male, aged 58 ± 18 years at diagnosis were included. Recurrent infections revealed MKS in 88% of cases. Main comorbid conditions were diffuse bronchiectasis in 88% of patients and Tracheobronchomalacia in 67% of cases. The exacerbation rate was 1.5 exacerbations/patient/year. The main non-respiratory morbid condition was gastroesophageal reflux disease in 29% of cases. Interventional bronchoscopy was performed in seven patients (41%), consisting of laser (n = 2) and tracheal stenting (n = 5). Complications related to stents were observed in 80% of cases with a mean stent duration of 8 months. Four deaths, including three due to respiratory causes, occurred during follow-up. Conclusions: This is the largest series of MKS reported in the literature, showing that bronchiectasis and Tracheobronchomalacia are the main associated morbid conditions that constitute a challenge for treatment.
Anne B. Chang - One of the best experts on this subject based on the ideXlab platform.
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The role of the pediatrician in caring for children with Tracheobronchomalacia
Expert Review of Respiratory Medicine, 2020Co-Authors: Manisha Ramphul, Anne B. Chang, Andrew Bush, Kostas N Prifits, C Wallis, Jayesh M. BhattAbstract:Children with Tracheobronchomalacia (TBM) experience excessive dynamic collapse of the central airway(s). TBM remains an under-diagnosed condition, and there is on ongoing need to raise awareness a...
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a comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of Tracheobronchomalacia in children
Pediatric Pulmonology, 2017Co-Authors: Ian B. Masters, Helen M. Buntain, Kieran Frawley, Anubhav Sarikwal, Debbie Watson, Frances Ware, Jan Wuth, Anne B. ChangAbstract:INTRODUCTION Flexible bronchoscopy (FB) is the current gold standard for diagnosing Tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing Tracheobronchomalacia. METHODS Children aged <18-years scheduled for FB and MDCT were recruited. FB and MDCT were undertaken within 30-min to 7-days of each other. Tracheobronchomalacia (mild, moderate, severe, very severe) diagnosed on FB were independently scored by two pediatric pulmonologists; VB was independently scored by two pairs (each pair = pediatric pulmonologist and radiologist), in a blinded manner. RESULTS In 53 children (median age = 2.5 years, range 0.8-14.3) evaluated for airway abnormalities, tracheomalacia was detected in 37 (70%) children at FB. Of these, VB detected tracheomalacia in 20 children, with a sensitivity of 54.1% (95%CI 37.1-70.2), specificity = 87.5% (95%CI 60.4-97.8), and positive predictive value = 90.9% (95%CI 69.4-98.4). The agreement between pediatric pulmonologists for diagnosing tracheomalacia by FB was excellent, weighted κ = 0.8 (95%CI 0.64-0.97); but only fair between the pairs of pediatric pulmonologists/radiologists for VB, weighted κ = 0.47 (95%CI 0.23-0.71). There were 42 cases of bronchomalacia detected on FB. VB had a sensitivity = 45.2% (95%CI 30.2-61.2), specificity = 95.5% (95%CI 94.2-96.5), and positive predictive value = 23.2 (95%CI 14.9-34.0) compared to FB in detecting bronchomalacia. CONCLUSION VB cannot replace FB as the gold standard for detecting Tracheobronchomalacia in children. However, VB could be considered as an alternative diagnostic modality in children with symptoms suggestive of Tracheobronchomalacia where FB is unavailable. Pediatr Pulmonol. 2017;52:480-486. © 2016 Wiley Periodicals, Inc.
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A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of Tracheobronchomalacia in children
Pediatric Pulmonology, 2016Co-Authors: Ian B. Masters, Helen M. Buntain, Kieran Frawley, Anubhav Sarikwal, Debbie Watson, Frances Ware, Jan Wuth, Anne B. ChangAbstract:INTRODUCTION Flexible bronchoscopy (FB) is the current gold standard for diagnosing Tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing Tracheobronchomalacia. METHODS Children aged
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Tracheobronchomalacia in children
Expert Review of Respiratory Medicine, 2009Co-Authors: Ian B. Masters, Anne B. ChangAbstract:Tracheobronchomalacia disorders present a considerable diagnostic challenge and workload to tertiary pediatrics. Bronchoscopy is the definitive way of confirming these diagnoses. Quantification of the size of lesions with a reference point is important to the decision-making processes for management, yet this aspect of assessment has been left to subjective visual estimates of size, even though there are now methods available for quantitative measurement. There is a wide range of bronchoscopic appearances and clinical manifestations of these disorders, and a spectrum of resultant diseases. At the mild end of the spectrum of illnesses, the clinical profiles are worse than similar respiratory illnesses in normal children. At the moderate and severe ends of the spectrum, invasive interventions, operative approaches and intensive care management are often necessary. Generally, these disorders are thought to improve with increasing age, but exactly which types and to what extent these disorders actually do improve or resolve are not known. Research is necessary to establish a true definition of these disorders to establish an improved understanding of the clinical profiles of the various appearance and types of malacia. Randomized, controlled studies of the management of malacia disorders, including research on potentially curative medical molecular genetic therapies, will be beneficial to pediatric respiratory medicine and ultimately the care of children with these disorders.
Pierre Schmitt - One of the best experts on this subject based on the ideXlab platform.
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Respiratory Conditions Associated with Tracheobronchomegaly (Mounier-Kuhn Syndrome): A Study of Seventeen Cases
Respiration, 2016Co-Authors: Pierre Schmitt, Hervé Dutau, Levent Dalar, Stéphane Jouneau, Bénédicte Toublanc, Juliette Camuset, Gérard Chatte, Laurent Cellerin, Stéphane Sanchez, Maxime SauvageAbstract:Background: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by enlargement of the trachea and main bronchi and associated with recurrent respiratory tract infections. Objective: This multicenter, retrospective study was carried out to describe respiratory conditions associated with tracheobronchomegaly. Methods: Nine institutions involved in the ‘Groupe d'Endoscopie de Langue Française' (GELF) participated in this study. A standard form was used to record patient characteristics, treatments and follow-up from medical charts. Results: Seventeen patients, 53% male, aged 58 ± 18 years at diagnosis were included. Recurrent infections revealed MKS in 88% of cases. Main comorbid conditions were diffuse bronchiectasis in 88% of patients and Tracheobronchomalacia in 67% of cases. The exacerbation rate was 1.5 exacerbations/patient/year. The main non-respiratory morbid condition was gastroesophageal reflux disease in 29% of cases. Interventional bronchoscopy was performed in seven patients (41%), consisting of laser (n = 2) and tracheal stenting (n = 5). Complications related to stents were observed in 80% of cases with a mean stent duration of 8 months. Four deaths, including three due to respiratory causes, occurred during follow-up. Conclusions: This is the largest series of MKS reported in the literature, showing that bronchiectasis and Tracheobronchomalacia are the main associated morbid conditions that constitute a challenge for treatment.
Hervé Dutau - One of the best experts on this subject based on the ideXlab platform.
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Respiratory Conditions Associated with Tracheobronchomegaly (Mounier-Kuhn Syndrome): A Study of Seventeen Cases
Respiration, 2016Co-Authors: Pierre Schmitt, Hervé Dutau, Levent Dalar, Stéphane Jouneau, Bénédicte Toublanc, Juliette Camuset, Gérard Chatte, Laurent Cellerin, Stéphane Sanchez, Maxime SauvageAbstract:Background: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by enlargement of the trachea and main bronchi and associated with recurrent respiratory tract infections. Objective: This multicenter, retrospective study was carried out to describe respiratory conditions associated with tracheobronchomegaly. Methods: Nine institutions involved in the ‘Groupe d'Endoscopie de Langue Française' (GELF) participated in this study. A standard form was used to record patient characteristics, treatments and follow-up from medical charts. Results: Seventeen patients, 53% male, aged 58 ± 18 years at diagnosis were included. Recurrent infections revealed MKS in 88% of cases. Main comorbid conditions were diffuse bronchiectasis in 88% of patients and Tracheobronchomalacia in 67% of cases. The exacerbation rate was 1.5 exacerbations/patient/year. The main non-respiratory morbid condition was gastroesophageal reflux disease in 29% of cases. Interventional bronchoscopy was performed in seven patients (41%), consisting of laser (n = 2) and tracheal stenting (n = 5). Complications related to stents were observed in 80% of cases with a mean stent duration of 8 months. Four deaths, including three due to respiratory causes, occurred during follow-up. Conclusions: This is the largest series of MKS reported in the literature, showing that bronchiectasis and Tracheobronchomalacia are the main associated morbid conditions that constitute a challenge for treatment.
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Endoscopic successful management of Tracheobronchomalacia with laser: apropos of a Mounier-Kuhn syndrome.
European Journal of Cardio-Thoracic Surgery, 2011Co-Authors: Hervé Dutau, Fabien Maldonado, David P. Breen, Arlette ColchenAbstract:Mounier-Kuhn syndrome is a rare condition that combines tracheobronchomegaly (TBM) and severe Tracheobronchomalacia. Symptoms can be severe with recurrent bronchopulmonary infections and cough-induced syncope. Therapeutic management is non-specific and limited to chest physiotherapy and antibiotics during infectious exacerbations. We report a case of Mounier-Kuhn syndrome that was successfully managed by treating the posterior collapse of the central airway with yttrium aluminum pevroskyte laser. Endoscopic aspects, respiratory symptoms, and lung function tests all improved and remained stable with a follow-up of 8 years. Laser, at low power settings, could be a new therapeutic option in selected cases of Tracheobronchomalacia.
Ian B. Masters - One of the best experts on this subject based on the ideXlab platform.
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a comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of Tracheobronchomalacia in children
Pediatric Pulmonology, 2017Co-Authors: Ian B. Masters, Helen M. Buntain, Kieran Frawley, Anubhav Sarikwal, Debbie Watson, Frances Ware, Jan Wuth, Anne B. ChangAbstract:INTRODUCTION Flexible bronchoscopy (FB) is the current gold standard for diagnosing Tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing Tracheobronchomalacia. METHODS Children aged <18-years scheduled for FB and MDCT were recruited. FB and MDCT were undertaken within 30-min to 7-days of each other. Tracheobronchomalacia (mild, moderate, severe, very severe) diagnosed on FB were independently scored by two pediatric pulmonologists; VB was independently scored by two pairs (each pair = pediatric pulmonologist and radiologist), in a blinded manner. RESULTS In 53 children (median age = 2.5 years, range 0.8-14.3) evaluated for airway abnormalities, tracheomalacia was detected in 37 (70%) children at FB. Of these, VB detected tracheomalacia in 20 children, with a sensitivity of 54.1% (95%CI 37.1-70.2), specificity = 87.5% (95%CI 60.4-97.8), and positive predictive value = 90.9% (95%CI 69.4-98.4). The agreement between pediatric pulmonologists for diagnosing tracheomalacia by FB was excellent, weighted κ = 0.8 (95%CI 0.64-0.97); but only fair between the pairs of pediatric pulmonologists/radiologists for VB, weighted κ = 0.47 (95%CI 0.23-0.71). There were 42 cases of bronchomalacia detected on FB. VB had a sensitivity = 45.2% (95%CI 30.2-61.2), specificity = 95.5% (95%CI 94.2-96.5), and positive predictive value = 23.2 (95%CI 14.9-34.0) compared to FB in detecting bronchomalacia. CONCLUSION VB cannot replace FB as the gold standard for detecting Tracheobronchomalacia in children. However, VB could be considered as an alternative diagnostic modality in children with symptoms suggestive of Tracheobronchomalacia where FB is unavailable. Pediatr Pulmonol. 2017;52:480-486. © 2016 Wiley Periodicals, Inc.
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A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of Tracheobronchomalacia in children
Pediatric Pulmonology, 2016Co-Authors: Ian B. Masters, Helen M. Buntain, Kieran Frawley, Anubhav Sarikwal, Debbie Watson, Frances Ware, Jan Wuth, Anne B. ChangAbstract:INTRODUCTION Flexible bronchoscopy (FB) is the current gold standard for diagnosing Tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing Tracheobronchomalacia. METHODS Children aged
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Tracheobronchomalacia in children
Expert Review of Respiratory Medicine, 2009Co-Authors: Ian B. Masters, Anne B. ChangAbstract:Tracheobronchomalacia disorders present a considerable diagnostic challenge and workload to tertiary pediatrics. Bronchoscopy is the definitive way of confirming these diagnoses. Quantification of the size of lesions with a reference point is important to the decision-making processes for management, yet this aspect of assessment has been left to subjective visual estimates of size, even though there are now methods available for quantitative measurement. There is a wide range of bronchoscopic appearances and clinical manifestations of these disorders, and a spectrum of resultant diseases. At the mild end of the spectrum of illnesses, the clinical profiles are worse than similar respiratory illnesses in normal children. At the moderate and severe ends of the spectrum, invasive interventions, operative approaches and intensive care management are often necessary. Generally, these disorders are thought to improve with increasing age, but exactly which types and to what extent these disorders actually do improve or resolve are not known. Research is necessary to establish a true definition of these disorders to establish an improved understanding of the clinical profiles of the various appearance and types of malacia. Randomized, controlled studies of the management of malacia disorders, including research on potentially curative medical molecular genetic therapies, will be beneficial to pediatric respiratory medicine and ultimately the care of children with these disorders.
