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This was presumably because the relatively short right main bronchus meant that the right upper lobe bronchus could not be aligned with the bronchial ventilation orifice of the double-lumen tube, and the bronchial cuff therefore herniated out into the trachea through the carina, obstructing (at least partially) ventilation of the left lung via the tracheal orifice of the tube. In addition, we believe that even http://www.selleckchem.com/products/VX-770.html when the tube could be placed adequately initially, a relatively small area of contact between the tube and the right main bronchus may have made it more likely that the tube moved out when the patient was repositioned on to his/her side. The relatively low incidence of tube malposition in the group of patients with a CT distance >?23?mm is comparable with that reported in a previous study [2], which also demonstrated comparable results when using right- or left-sided tubes. Despite the relatively high incidence of tube malposition in the CT distance http://www.selleck.cn/products/mi-773-sar405838.html as demonstrated by fibreoptic bronchoscopy, was not sufficient to interfere with one-lung ventilation, or that early correction of tube malposition after turning the patients on to their side was effective. The length of the right main bronchus has been previously measured using plain X-ray [9]; however, this approach may be limited by the fact that the bronchial outline is clearly identifiable in only 50% of chest X-ray films [12]. Benumof and colleagues [1] measured left and right main bronchus length in vivo, on autopsy, and from a lung cast, these methods yielding nearly identical http://www.selleckchem.com/products/Imatinib-Mesylate.html dimensions for main bronchus length. We believe that CT can identify the bronchial wall more precisely than X-ray, thus facilitating pre-operative measurement of upper airway dimensions in most patients undergoing thoracic surgery. Our results also suggest that the measurement of distance from a CT scan is reliable because this measurement was similar to that obtained using the fibreoptic bronchoscope in our study; however, we did not measure the length of the right main bronchus itself. In general, the distal margin of the right upper lobe bronchus orifice is clear on CT, compared with the proximal margin which is obscure. Hence, we chose to measure the distance between the carina and the distal margin for our study, as opposed to measuring the length of the right main bronchus. The mean (SD) length of the right main bronchus has previously been shown to be 17 (8)?mm, and the diameter of the right upper lobe bronchial orifice 10.7 (2.1)?mm [1].