title: Mild tracheal compression by aberrant innominate artery and chronic dry cough in children.
abstract: BACKGROUND
  In children with aberrant innominate artery (AIA) one of the most prevalent respiratory symptom is dry cough. How frequently this mediastinal vessels anomaly, that can induce tracheal compression (TC) of different degree, may be detected in children with chronic dry cough is not known.
  
  
  METHODS
  In a 3-year retrospective study, the occurrence of mediastinal vessels abnormalities and the presence and degree of TC was evaluated in children with recurrent/chronic dry cough.
  
  
  RESULTS
  Vascular anomalies were detected in 68 out of the 209 children evaluated. A significant TC was detected in 54 children with AIA, in eight with right aortic arch, in four with double aortic arch but not in two with aberrant right subclavian artery. In AIA patients, TC evaluated on computed tomography scans, was mild in 47, moderate in six and severe in one. During bronchoscopy TC increased in expiration or during cough, but this finding was more pronounced in children with right aortic arch and double aortic arch in which a concomitant tracheomalacia was more evident. Comorbidities were detected in 21 AIA patients, including atopy, reversible bronchial obstruction and gastroesophageal reflux. Aortopexy was performed in eight AIA patients, while the remaining AIA patients were managed medically and showed progressive improvement with time.
  
  
  CONCLUSIONS
  Mild TC induced by AIA can be detected in a sizeable proportion of children with recurrent/chronic dry cough. The identification of this anomaly, that may at least partially explain the origin of their symptom, may avoid further unnecessary diagnostic examinations and ineffective chronic treatments.
authors.affiliation: Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ghezzi
authors.affiliation: Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Silvestri
authors.affiliation: Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Sacco
authors.affiliation: Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Panigada
authors.affiliation: Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Donata
authors.initials: D
authors.lastname: Girosi
authors.affiliation: Radiology Department, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Gian Michele
authors.initials: GM
authors.lastname: Magnano
authors.affiliation: Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Rossi
mesh_terms: D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D016122:Brachiocephalic Trunk / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000098:blood supply / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D055090:Tracheomalacia / Q000000981:diagnostic imaging / Q000209:etiology*; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging
keywords: aortic arch anomalies; bronchoscopy; mediastinal vessel abnormalities