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There is extensive narrowing of the trachea. The proximal trachea is normal in calibre. It is severely narrowed at the level of the medial ends of the clavicles at the site of the previous tracheostomy where measures <6 mm. There are multiple filling defects at this level however it is difficult to determine whether this represents sputum or mural lesions. An anterior filling defect is seen more superiorly. Extending from this severely narrowed region in the trachea continues to be narrowing throughout its length most of which measures <1 cm. It has an abnormally rounded shape and an appearance consistent with complete tracheal rings. There is a tracheal bronchus on the right to the right upper lobe.
At the are extensive, large areas of abnormally reduced lung density in the left upper and lower lobes with associated air trapping and mosaic perfusion. These are likely due to further airway abnormality, presumably also congenital. Irregular collapse is identified in the left upper lobe adjacent to the region of abnormally reduced density.
Previously identified findings of marked pulmonary artery enlargement ? Pulmonary hypertension and anomalous pulmonary drainage of the right upper and middle lobes into the SVC are unchanged.
Previous thoracotomies. Scoliosis and thoracic degenerative disease.