Pediatric Flexible Bronchoscopy Course

Course Outline

click on each topic to see a detailed 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
Video laboratory – normal airway anatomy
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
BAL – indications and technique
BAL – interpretation of findings
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
The care and feeding of flexible bronchoscopes
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