THROAT - Bronchoscopy

What is Bronchoscopy?

Definition : Bronchoscopy is the examination of the tracheobronchial tree by an instrument called the bronchoscope.
The bronchoscope can be rigid or flexible.
In ENT practice rigid bronchoscopy is performed.

What are its Indications?

I. Diagnostic:
1.      Patient having persistent unexplained cough or haemopytsis
for more than 5-6 weeks.
2.      Bronchial lavage and cytological examination of bronchial
secretions.
3.      Malignancy of bronchus for biopsy.
4.      Atelectasis of the lung.
5.      Unexplained obstructive emphysema to rule out a foreign
body. ·
6.      Cases of recurrent laryngeal nerve palsy.
7.      To know the effect of radiation in bronchial tumours.
8.      Lung abscess.
9.      Fungal diseases of the tracheobronchial tree like,         actinomycosis,     blastomycosis and histoplasmosis. Bronchial secretions inoculated
on special media will identify the fungi.

 

II.      Therapeutic :
1.      Removal of foreign bodies.
2.      Removal of retained bronchial secretions in unconscious or
head injury patients.
3.      Dilatation procedure for tracheal stenosis cases.
4.      Bronchoscopically implanted radium seeds in bronchus for
malignancies.

 

What are the complications of Bronchoscopy?

Complications of bronchoscopy :
1. Damage to tongue, teeth, lips, vocal cords or bronchii
2. Cardiac arrest
3. Dislocation to cervical vertebra
4. Bleeding
5. Laryngeal trauma

What are contra indications of Bronchoscopy?

Contraindications to bronchoscopy:
Rigid bronchoscopy has to be performed by an experienced surgeon in a well equipped operation set up.
Emergency bronchoscopy especially for foreign body removal has no contraindication.

Other contraindications:
1.      Cervical spondylosis or other cervical vertebral column diseases
are relative contraindications as dislocation of the cervical spine
may occur.
2.      Presence of active haemorrhage is a temporary contraindication.
3.      Active syphilitic infection should be controlled prior to         bronchoscopy.
4.      Aortic aneurysm.
5.      Severe cardiovascular disease.




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