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Bronchoscopy

Bronchospopy at Karnataka ENT Hospital & Research Center (R)

 

bronchoscope1Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy (A opening in the wind pipe made in the lower neck). This allows the surgeon to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs: biopsies, fluid (bronchoalveolar lavage), or endobronchial brushing. The bronchoscopes are of two types: rigid metal tubes with attached lighting devices and flexible fibreoptic bronchoscopes. The flexible fibreoptic bronchoscopes also come with realtime video equipment.

 

            (Picture Courtesy: ADAM)


 

Flexible (fiberoptic) Bronchoscope

flexible bronchoscopy

A flexible bronchoscope contains a fiberoptic system that transmits an image from the tip of the instrument to an eyepiece or video camera at the opposite end. Most flexible bronchoscopes also include a channel for suctioning or instrumentation, but these are significantly smaller than those in a rigid bronchoscope.

Flexible bronchoscopy cause less discomfort for the patient than rigid bronchoscopy and the procedure can be performed easily and safely under local anesthesia. It is nowaday the technique of choice for most bronchoscopic procedures.

 

 


Rigid Bronchoscope

rigid bronchsocopyA rigid bronchoscope is a straight, metal tube with an inner diameter of up to one centimetre. It is inserted through the mouth, the patient lying in a supine position and the neck hyper extended. The procedure causes significant discomfort and is performed under general anesthesia.

Rigid bronchoscopy is less often used today, but it remains the procedure of choice for removing foreign materials, as the greater diameter of the rigid bronchoscope allows instruments to be more easily inserted through it. Rigid bronchoscopy also becomes useful when bleeding interferes with viewing the examining area, and allows for more interventions, such as cautery to stop the bleeding.

 


Purposes of Bronchoscopy

bronchoscope(Picture Courtesy: National Cancer Institute)

Diagnostic :

To view abnormalities of the airway

To obtain tissue specimens of the lung in a variety of disorders

To evaluate a person who has bleeding in the lungs , possible lung cancer, a chronic cough, or a collapsed lung

Therapeutic :

To remove secretions, blood, or foreign objects lodged in the airway

Laser resection of tumors or benign tracheal and bronchial strictures

Stent insertion to palliate extrinsic compression of the tracheobronchial lumen from either malignant or benign disease processes

Bronchoscopy is also employed in percutaneous tracheostomy

Surgical procedures on the airways, such as tracheal reconstruction, often require the use of bronchoscopy

Intubation of patients with difficult airways is often performed using a flexible bronchoscope


 

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