title: Tracheobronchomalacia and air trapping after mustard gas exposure.
abstract: BACKGROUND
  Mustard gas primarily affects the eyes, skin, and particularly the respiratory tract. Tracheobronchomalacia (TBM) and air trapping are often observed in high-resolution computerized tomography (HRCT) scans of the chest of mustard gas-exposed patients.
  
  
  OBJECTIVE
  To examine the frequency and severity of TBM in a group of Iranian wartime mustard gas-exposed victims, and to investigate the correlation between TBM and air trapping in these cases.
  
  
  METHODS
  Chest HRCT films obtained from 300 randomly selected subjects who had been exposed to mustard gas 15.5 yr previously were reviewed to determine the existence of TBM and air trapping. The HRCT films of a healthy control group were also analyzed for comparison.
  
  
  RESULTS
  Out of 300 reviewed cases, 13 had TBM. From these 13 TBM cases, 11 (85%) showed air trapping with mean score of 5.5. In the control group, 5 (25%) of 20 subjects showed air trapping, with mean score of 0.6. The total air trapping was significantly higher in the TBM group (p < 0.001). There was an association between the severity of tracheomalacia and air trapping in the TBM group (p = 0.01, r = 0.69), but no association was observed between severity of bronchomalacia and air trapping.
  
  
  CONCLUSIONS
  The results show that air trapping and TBM are correlated, both as long-term sequelae in mustard gas-exposed cases. Because air trapping is highly suggestive of bronchiolitis obliterans, we conclude that both bronchiolitis obliterans and TBM are caused by a single underlying process affecting small and large airways, respectively, in this group of patients.
authors.affiliation: Research Center of Chemical Injuries, Baqiyatallah Medical Science University, Mollasadra Street, Tehran, 14359151371, Iran. m.ghanei@bmsu.ac.ir
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ghanei
authors.forename: Farhad
authors.initials: F
authors.lastname: Akbari Moqadam
authors.forename: Mehdi Mir
authors.initials: MM
authors.lastname: Mohammad
authors.forename: Jafar
authors.initials: J
authors.lastname: Aslani
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D001982:Bronchial Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002357:Cartilage Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D002618:Chemical Warfare; D002619:Chemical Warfare Agents / Q000633:toxicity*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure; D007492:Iran; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000633:toxicity*; D011859:Radiography; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D014133:Tracheal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D002619:Chemical Warfare Agents; D009151:Mustard Gas