Major anatomical variations in the division of tracheobronchial tree as visualised by fiberoptic bronchoscopy - A study of 500 cases

Fiber optic bronchoscopy is a tool that is widely used for diagnostic and therapeutic purposes in pulmonary medicine. Though variations in tracheobronchial divisions are well known, investigators often tend to neglect them during bronchoscopies. These variations may have important implications in intubation, bronchoscopy, brachytherapy, bronchial thermoplasty and pulmonary resections. Though there have been reports of variations in anatomy of the tracheobronchial tree, there hasn't been a study regarding the same in the Indian population in our knowledge. In the present study we retrospectively analyzed 500 cases of fiberoptic bronchoscopies, done over a period of four and half years. Major variations were found in 29(5.8%) patients. Commonest variation was found in right upper lobe 18 (62.06%) followed by left upper lobe (17.56%). 35.7% patients had four divisions in right lobe. 28.2% patients had two divisions in right upper lobe. 17. 56% patients had four divisions in left upper lobe.