Bronch Course Outline

  • General concepts – what bronchoscopy is and what it is not
    Instrumentation for bronchoscopy
          Rigid instruments
          Flexible instruments
    Pediatric vs adult bronchoscopy
    Indications for bronchoscopy
    Contraindications to bronchoscopy
    Rigid vs flexible bronchoscopy – pros and cons
    Rigid and flexible bronchoscopy – 1+1=3
    Complications of bronchoscopy

  • Mechanics of flexible bronchoscopes
    The crucial role of hand position
    Directing the tip of the scope

  • Tracheomalacia
    Bronchomalacia
    Vascular compression
    Intrinsic airway mass lesions
    Tracheobronchial foreign bodies
    Atelectasis
    Cystic fibrosis
    Recurrent or persistent pneumonia
    Acute pneumonia
    Bronchoscopy in asthma
    Tracheoesophageal fistula
    Complete tracheal rings
    Bronchoscopy in tracheotomized patients
    Hemoptysis
    Indications for rigid bronchoscopy

  • Illustrative cases

  • The upper airways are a crucial aspect of diagnostic flexible bronchoscopy…
    Laryngomalacia
    Pharyngomalacia
    Laryngeal edema
    Laryngeal stenosis – subglottic, glottic, supraglottic
    Laryngeal mass lesions
    Laryngeal cysts
    Vocal cord paralysis
    Laryngeal webs
    Laryngoesophageal clefts
    Laryngeal foreign bodies
    Adenoidal, tonsillar, lingual tonsillar hypertrophy
    Glossoptosis
    Cleft palate
    Nasolacrimal duct cysts

  • Illustrative cases

  • Equipment
    Setup
    Positioning the patient
    Handling the scope
    Foreign body management
    Complications of rigid bronchoscopy
    Challenges of rigid bronchoscopy

  • History of tracheostomy
    Indications and timing
    Technique for tracheotomy
    Tube selection
    Complications and their prevention/management
    Decannulation

  • Techniques and tools
          Endoscopic
                Dilation
                Laryngeal cysts
                Laryngomalacia/supraglottoplasty
                Laryngeal webs
                Vocal cord paralysis
                Laryngoesophageal clefts
                Tracheoesophageal fistula
                Tracheal pouch
          Open surgical
                Laryngotracheal reconstruction
                Slide tracheoplasty

  • Voice evaluation
    Reflux and the larynx
    Vocal cord lesions
          Cysts
          Papillomata
    Vocal cord paralysis
          Injection
          Re-innervation
    Paradoxical vocal cord dysfunction
    Voice after laryngotracheal reconstruction

  • Principles
    Airway management

  • Bronchoscopic intubation
    Transbronchial biopsy
    Endobronchial biopsy
    Bronchial brushing
    BAL – concepts
    Whole lung lavage
    Bronchoscopy in patients with tracheostomies
    Retrograde laryngoscopy
    Bronchoscopy via endotracheal tubes, LMA’s
    Bronchography
    Esophagoscopy with a bronchoscope
    Dilation techniques
    Laser applications
    Cautery applications
    Foreign body management
    Stents
    Bronchopleural fistula – diagnosis and management
    Cryoprobes
    Endobronchial ultrasound
    Argon plasma coagulation
    Research applications in pediatrics

  • Cone-beam CT guided evaluation of peripheral lung lesions
    Whole lung lavage techniques for PAP
    Cryoprobe in the management of endobronchial lesions

  • The team: bronchoscopists, assistants, anesthesiologists/sedation nurse, scheduler
    The venue
    Equipment
    Data management
    Specimen management
    Communication
    Billing and business matters

  • Basic principles – “to understand the question is half an answer…”
    Recommendations for further training