Innominate artery compression of the trachea: Current concepts

One common vascular anomaly that causes airway obstruction in neonates and infants is innominate artery compression of the trachea. A great deal of controversy exists regarding the effect of this anatomic variant on symptom production. Several cases are presented that demonstrate the unique features of innominate artery compression of the trachea: 1. Innominate artery compression can occur in adolescent patients. 2. Flow volume loops are an effective method of documenting airway compromise in this condition. 3. Exercise intolerance should be considered as a relative indication for surgical intervention in these patients. 4. Reimplantation of the innominate artery is a viable surgical alternative in the treatment of affected patients. 5. Telescopic bronchoscopy during surgical correction of this condition will ensure that there has been successful correction of the tracheal compression. 6. Urgent repair is advocated in patients who experience periods of apnea.     

Magnetic resonance imaging in the diagnosis of innominate artery compression of the trachea

In the past, the diagnosis of tracheal compression by intrathoracic arterial structures has been made by using bronchoscopy alone or in combination with one of a variety of imaging techniques, including barium contrast esophagography and cineangiography. However, all of these imaging techniques involve exposure of patients to ionizing radiation and, in the case of angiography, an invasive procedure. The use of magnetic resonance imaging in the diagnosis of thoracic arterial disease is well documented and, more specifically, has been found to be useful in the diagnosis of innominate artery compression of the trachea and congenital vascular rings. This report documents the use of magnetic resonance imaging at the Children's Hospital Medical Center, Cincinnati, Ohio, in the diagnosis of innominate artery compression of the trachea. In addition, the radiographic appearance of this entity is contrasted with other compressive lesions of the trachea.     

Imaging of the age-related anatomical relationship between the innominate artery and the trachea

European Archives of Oto-Rhino-Laryngology - To measure the age-dependent changes of anatomical positions and relations between the trachea, cricoid cartilage (CC), and innominate artery (IA) in...     

Vertigo caused by basilar artery compression of the eighth nerve

Vascular compression syndromes in the posterior cranial fossa have become well described clinical entities, especially for the fifth and seventh cranial nerves. Jannetta has proposed vascular compression of the eighth nerve as the etiology of hearing loss, tinnitus, and vertigo in some patients. The case that follows illustrates a clear-cut example of vestibular symptoms arising from vascular compression of the eighth nerve. The patient involved had disabling peripheral vertigo refractory to medical management. Magnetic resonance imaging documented a tortuous basilar artery compressing the eighth nerve on the involved side. This was confirmed at surgery, and a selective section of the vestibular nerve provided complete relief of disabling symptoms and preservation of hearing. The authors describe the details of this case and the enigma of eighth nerve symptoms due to vascular compression.     

Rhabdomyosarcoma of the trachea

A 12-year-old girl was admitted on two occasions to our department because of severe dyspnoea, necessitating emergency tracheostomy. On the second admission, a lateral neck X-ray demonstrated a globular tumour which was found to be an embryonal rhabdomyosarcoma. The patient received post-operative radiation therapy followed by two years of continued chemotherapy. She is now five years post diagnosis and requiring no further therapy for about three years and her condition remains in remission.     

Leiomyosarcoma of the trachea

A case of primary leiomyosarcoma in the trachea of a 63-year-old woman is presented. Owing to the rare occurrence of this tumour in this site, the clinical diagnosis and pathological classification are difficult. In the English literature, only six cases of primary leiomyosarcoma in the trachea are on record.