{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:50:10Z","timestamp":1792057810748,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital lung malformations (CLMs) are heterogeneous developmental anomalies caused by disrupted airway branching morphogenesis, but whether the central airways are also involved remains unclear. We quantified infant tracheobronchial dimensions in CLMs and compared them with published infant reference values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single\u2010center study included 81 of 94 infants with CLMs assessed for eligibility. Exclusions were secretions preventing measurement (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), motion artifacts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), unavailable preoperative computed tomography (CT) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), and missing diagnosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Chest CT was performed before 1 year of age and before surgery. Tracheobronchial cross\u2010sectional areas (CSAs) were measured at five standardized levels, natural\u2010log transformed, and compared with expected values from the Chalwadi et al. equations for age 0 completed years. Holm correction was applied to the five overall comparisons; diagnostic subgroup and regression analyses were exploratory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diagnoses were congenital pulmonary airway malformation (CPAM,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940), pulmonary sequestration (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927), congenital lobar emphysema (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), bronchial atresia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), and bronchogenic cyst (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Compared with expected values, the overall cohort showed larger proximal tracheal CSA (log\n                      <jats:sub>e<\/jats:sub>\n                      3.22 vs. 3.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021; Holm\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), distal tracheal CSA (3.33 vs. 3.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010; Holm\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030), right main bronchus (2.91 vs. 2.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007; Holm\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028), and left main bronchus (2.57 vs. 2.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002; Holm\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), with no mid\u2010tracheal difference (3.20 vs. 3.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.233; Holm\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.233). CPAM showed enlargement of the proximal trachea (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), distal trachea (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), right main bronchus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017), and left main bronchus (2.62 vs. 2.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017). Pulmonary sequestration showed no significant differences. Congenital lobar emphysema showed reduced mid\u2010tracheal CSA (2.86 vs. 3.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). Bronchial atresia showed enlarged proximal trachea (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027), distal trachea (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027), and left main bronchus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CLMs are associated with quantifiable tracheobronchial alterations during infancy, with distinct subtype\u2010specific patterns. These findings suggest that CLMs may represent disorders of global airway development rather than isolated parenchymal abnormalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71876","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:36:20Z","timestamp":1792056980000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Congenital Lung Malformations and Quantitative Assessment of Infant Tracheal\u2013Bronchial Dimensions"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1812-6114","authenticated-orcid":false,"given":"Antonio Mario","family":"Bulfamante","sequence":"first","affiliation":[{"name":"Paediatric Otolaryngology Unit, Department of Paediatric Surgery \u201cV. Buzzi\u201d Children Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7370-5122","authenticated-orcid":false,"given":"Ugo Maria","family":"Pierucci","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Campari","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1790-4618","authenticated-orcid":false,"given":"Salvatore","family":"Zirpoli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1008-6632","authenticated-orcid":false,"given":"Carlotta","family":"Ardenghi","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Ceresola","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"Paediatric Otolaryngology Unit, Department of Paediatric Surgery \u201cV. Buzzi\u201d Children Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3529-1437","authenticated-orcid":false,"given":"Irene","family":"Paraboschi","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery \u201cV. Buzzi\u201d Children's Hospital Milan Italy"},{"name":"Department of Biomedical and Clinical Science University of Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Camporesi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia and Intensive Care \u201cV. Buzzi\u201d Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Pelizzo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery \u201cV. Buzzi\u201d Children's Hospital Milan Italy"},{"name":"Department of Biomedical and Clinical Science University of Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2025.09.021"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/ped.13934","article-title":"Clinical Presentation and Outcome in Congenital Pulmonary Malformation: 25 Year Retrospective Study in Thailand","volume":"61","author":"Maneenil G.","year":"2019","journal-title":"Pediatrics International"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1038\/s41572-023-00470-1","article-title":"Congenital Lung Malformations","volume":"9","author":"Pederiva F.","year":"2023","journal-title":"Nature Reviews Disease Primers"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.18103\/mra.v13i7.6775"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1053\/j.ro.2024.03.005","article-title":"Pediatric Congenital Lung Malformations: Contemporary Perspectives on Imaging Characteristics","volume":"59","author":"Plut D.","year":"2024","journal-title":"Seminars in Roentgenology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25536"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/S2352-4642(18)30035-X","article-title":"Congenital Pulmonary Airway Malformation: Advances and Controversies","volume":"2","author":"Wong K. 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M.","year":"1990","journal-title":"RadioGraphics"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"638","DOI":"10.3390\/children11060638","article-title":"Congenital Lung Malformations: A Pictorial Review of Imaging Findings and a Practical Guide for Diagnosis","volume":"11","author":"Cancemi G.","year":"2024","journal-title":"Children"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jcma.2015.12.001","article-title":"Laryngotracheobronchial Anomalies in Infants and the Related Risk Factors of In\u2010Hospital Mortality","volume":"79","author":"Lee K.\u2010L.","year":"2016","journal-title":"Journal of the Chinese Medical Association"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.3390\/children9121881","article-title":"Congenital Lung Malformations: Clinical and Functional Respiratory Outcomes After Surgery","volume":"9","author":"Farolfi A.","year":"2022","journal-title":"Children"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25032"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07005"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13210"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24345"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71876","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71876","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:36:21Z","timestamp":1792056981000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/ppul.71876"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71876","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71876"}}