Flexible Fiberoptic Bronchoscopy

Techniques and Review of 100 Bronchoscopies

¹ Instructor in Medicine, Boston University School of Medicine
² Pulmonary Section, Department of Medicine, Veterans Administration Hosptal, and the Department of Medicine, Boston University School of Medicine, Boston
³ Professor of Medicine, Boston University School of Medicine

The use of a flexible fiberoptic instrument for diagnostic bronchoscopy in a pulmonary disease service is described, and the first 100 bronchoscopies are analyzed. The examination is performed at the bedside or in the treatment room under local anesthesia. Transnasal passage of the bronchoscope is the preferred route. The range of bronchoscopic view is greater than with the rigid bronchoscope, extending to subsegmental level. Itwas judged that flexible fiberoptic bronchoscopy yielded diagnoses in four of 24 cases where rigid tube bronchoscopy would likely have failed; a precise diagnosis of the cause of hemoptysis was made in 12 instances or 59 percent of 17 patients without parenchymal shadows in the chest roentgenogram. Bronchial brushing and biopsy are readily performed through the instrument, and patients on ventilatory assistance are easily examined through a tracheotomy or endotracheal tube. The procedure is well accepted by patients, and there have been no complications. The flexible bronchoscope should replace rigid tube bronchoscopy for diagnostic purposes.