Bronchoscopes

CT bronchus sign (BS) designates a bronchus leading directly to a peripheral pulmonary lesion. The objective of this investigation is to determine the contribution of BS-guided bronchoscopic multiple diagnostic procedures (BMDPs) to the diagnostic yield of solitary nodules or masses (SPNMs) suspected of pulmonary carcinoma (PC). A prospective study was carried out in 92 patients with a 2–5 cm diameter

Difficult airway management and maintenance of oxygenation remain the two most challenging tasks for anesthetists, while also being controversial items in terms of clinically based-evidence to support relevant guidelines in the literature. Nevertheless, different expert groups and scientific societies from several countries have published guidelines dedicated to the management of difficult airways. These documents have been demonstrated to be useful in reducing airway management related critical accidents, despite their limited use in litigations and legal issues. The aim of this review is to compare different airway management guidelines published by the United States, United Kingdom, France, Italy, Germany, and Canada while trying to elucidate the main differences, weaknesses, and strengths for identifying critical concepts in the management of difficult airways.

Foreign body (FB) aspiration is a common problem worldwide and its incidence has not decreased through time.47 Morbidity and mortality from nonasphyxiating tracheobronchial FBs, however, fortunately have declined with the advancement of bronchoscopy equipment and accessories, increased awareness of clinicians, and improvements of imaging technology.This article reviews the incidence and clinical presentation of airway FBs in adults and examines why the flexible bronchoscope has become the preferred initial diagnostic and therapeutic instrument. A discussion on removal techniques and new accessories for the flexible bronchoscope also is provided.

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Purpose About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the Trachlight™ (TL). Source To determine its clinical utility and limitations, we reviewed the current literature (book and journal articles) on the TL since its introduction in 1995. Principal findings TL has been shown to be useful both in oral and nasal intubation for patients with difficult airways. It may also be useful in “emergency” situations or when direct laryngoscopy or fiberoptic endoscopy is not effective, such as with patients who have copious secretions or blood in the oropharynx. TL can also be used for tracheal intubation in conjunction with other devices (laryngeal mask airway -LMA-, intubating LMA, direct laryngoscopy). However, TL should be avoided in patients with tumours, infections, trauma or foreign bodies in the upper airway. Conclusions Based on the clinical reports available, the TL has proven to be a useful option for tracheal intubation. In addition, the device can also be used together with other intubating devices, such as the intubating LMA and the laryngoscope, to improve intubating success rates. A clear understanding of the principle of transillumination of the TL, and an appreciation of its indications, contraindications, and limitations, will improve the effectiveness of the device as well as reducing the likelihood of complications. Finally, regular practice with the TL with routine surgical patients requiring tracheal intubation will further improve intubation success rates. Objectif La fréquence d’intubation difficile ou impossible varie de 1% à 3%. L’intubation trachéale avec le Trachlight™ (TL) représente une technique efficace, sûre et simple. Dans cet article nous voulons réviser les connaissances actuelles sur le stylet lumineux TL. Méthode Pour déterminer les applications et les limitations du TL, nous avons révisé la littérature (livres ou revues) sur le TL à partir de son introduction en 1995. Resultats Le TL permet une intubation oro-ou naso-trachéale dans différentes situations d’intubation difficile. Cette technique d’intubation avec le TL peut également être utile dans des situations d’urgence ou quand l’intubation trachéale avec le bronchoscope n’est pas indiquée, comme chez les patients qui présentent des sécrétions abondantes ou du sang dans l’oropharynx. Le TL peut également être utilisé pour l’intubation trachéale en même temps que d’autres dispositifs (masque laryngé, masque laryngé pour intubation, laryngoscopie directe). Cependant l’usage du TL devrait être évité chez les patients présentant une tumeur, une infection, un traumatisme ou un corps étranger dans les voies aériennes. Conclusion Selon les rapports cliniques à notre disposition, nous pouvons affirmer que le TL représente une solution de remplacement utile à la laryngoscopie traditionnelle. Le TL peut également être utilisé avec d’autre dispositifs comme le masque laryngé et la laryngoscopie directe pour augmenter le taux de réussite de l’intubation trachéale. En conclusion, la pratique régulière avec le TL et une connaissance de ses indications, contre-indications et limitations, peut améliorer l’efficacité du dispositif et réduire la probabilité de complications.

Infantile myofibromatosis is an uncommon and benign condition presenting in the neonatal period. It is self-limiting disease that may present as a localised or generalised process. Various examples of this entity have been reported in the literature. This report describes a neonate with a rapidly growing oropharyngeal lesion obstructing the airway that had the typical histological features of an infantile myofibroma. This case report highlights that a solitary myofibroma may be incredibly extensive making complete excision impossible and can be particularly challenging to manage in terms of airway stabilisation.

Although the diagnostic yield of guided bronchoscopy for peripheral pulmonary lesions has improved to 70%, it is still low compared with transthoracic needle aspiration. We produced a new bronchoscope with middle-range diameter and large channel (BF-Y0053, Olympus, Japan), and evaluated its diagnostic efficacy for peripheral pulmonary lesions. This was a retrospective study on 70 consecutive patients with peripheral pulmonary lesions who underwent diagnostic bronchoscopy using BF-Y0053 combined with endobronchial ultrasound with a guide sheath at the National Cancer Center Hospital from September 2013 to November 2013. Diagnostic performance of the procedure was analyzed and compared among three groups of peripheral pulmonary lesions: 'peripheral-small' lesions (≤ 30 mm and adjacent to visceral pleura), 'central-small' lesions (≤ 30 mm and not adjacent to the visceral pleura), and 'large' lesions (>30 mm). Sixty (85.7%) patients had malignant diseases. Dia...