gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKHC)

ISSN 1865-1038

Pictorial representation of trachea anatomy – misleading symbolism

Poster Aerodigestivtrakt

  • corresponding author Desislava Cherneva - Division of Otorhinolaryngology, Department of Neurosurgery and ENT diseases, Medical University, Varna, Bulgaria
  • Ivan Valkadinov - Division of Otorhinolaryngology, Department of Neurosurgery and ENT diseases, Medical University, Varna, Bulgaria
  • Nikolay Sapundzhiev - Division of Otorhinolaryngology, Department of Neurosurgery and ENT diseases, Medical University, Varna, Bulgaria
  • Anton Tonchev - Department of Anatomy, Histology and Embryology, Medical University, Varna, Bulgaria

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2017;13:Doc303

doi: 10.3205/cpo001857, urn:nbn:de:0183-cpo0018575

Published: April 26, 2017

© 2017 Cherneva et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Abstract

The cartilaginous skeleton of the trachea shows vast variations in its structure. These structural alterations encompass both the form and number of cartilaginous rings as well as the junctions between them. This anatomical feature seems to be frequently underestimated, despite its clinical significance in some surgical procedures.

A total of 110 publications were analyzed, including ENT, Anatomy, Surgery textbooks, atlases and articles. Both illustrations and text were checked if they represent/describe the tracheal cartilages as strictly parallel or having any deviation, e.g. non-parallel cartilages, bifurcated cartilages etc.

The publications studied were published in the time period from 1897 to 2016. Only 29% of the ENT textbooks contain tracheal illustrations with intercartilagineous variations. Illustrators of the Anatomy manuals and atlases both show alternating tracheal cartilage structure in 78% of the books. Merely 36% of Surgical textbooks and 20% of the articles show deviation from the parallel presentation of the tracheal rings. Deviations from the general schematic representation are located in the intrathoracic part of the trachea, with the cervical part being drawn as composed of parallel orientated cartilages only (65% of the sample vs. 27% parallel tracheal cartilages in the neck and thorax, respectively). Only in 4 sources (3.6%) the text specifies, that the tracheal rings are not uniform in shape and have common intercartilagineous contacts.

The illustrations of the trachea in the medical textbooks are deceivingly stylized, not corresponding to the real anatomical structure. This also applies to the text presented in medical literature. In certain surgical situations such a wrong and schematic concept may mislead the surgeon.

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