Specialist ENT INDICATIONS CONTRA INDICATIONS ANDCOMPLICATIONS OF BRONCHOSCOPY

INDICATIONS, CONTRA-INDICATIONS ANDCOMPLICATIONS OF BRONCHOSCOPY

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

Rigid bronchoscopy is used for removal of foreign bodies. It protects the airway and removes the foreign body under direct vision. 

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

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Indications:

I. Diagnostic:

  1. Patient having persistent unexplained cough or hemoptysis 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 tumors.
  8. Lung abscess.
  9. Fungal infections of the tracheobronchial tree like, actinomycosis, blastomycosis and histoplasmosis can be isolated on special media. Bronchial lavage can also be given.

II. Therapeutic:

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

Complications of bronchoscopy:

  1. Damage to tongue, teeth, lips, vocal cords or bronchi.
  2. Cardiac arrest.
  3. Dislocation to cervical vertebra.
  4. Bleeding.
  5. Laryngeal trauma.

Contraindications of bronchoscopy:

Rigid bronchoscopy has to be performed by an experienced surgeon in a well-equipped operation theatre.

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 hemorrhage 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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