Comparison of Virtual and Fiberoptic Bronchoscopy in the Management of Airway Stenosis

Abstract

Noninvasive imaging methods can be valuable tools for diagnosing thoracic diseases, especially malignancies. The aim of this study was to compare the effectiveness of conventional and virtual bronchoscopy in the follow-up of patients with large airway stenosis. Twenty-three consecutive patients with stenoses of the trachea and/or the main bronchi were enrolled in this prospective observer study. The causes of stenosis included malignant or benign tumours, goiter, and postintubation stenoses. Patients were evaluated before and after treatment (which included mechanical dilation, laser photocoagulation, stent implantation, radiotherapy, chemotherapy, and surgical resection). The mean time between baseline and follow-up endoscopy was 140 days. No significant differences were observed between the estimated and measured data from bronchofibroscopy and virtual bronchoscopy. Exact measurement of stenoses was performed with virtual bronchoscopy.

Measuring Central Airway Obstruction: What Do Bronchoscopists Do?

“…These findings support those previously reported by Murgu and Colt (10). In this study, evaluating the ability of 42 bronchoscopists to grade the degree of airway obstruction from benign airway strictures using still bronchoscopic images, only 47% of the strictures were correctly classified by (12,13). Unfortunately, methods relying upon axial imaging are expensive, remote from the point of bronchoscopy, impractical to perform frequently, may be hindered by secretions, and scanning may be difficult or unreasonable in critically ill patients.…”

Virtual endoscopy—a new assessment tool in difficult airway management

“…Virtual bronchoscopy was first described in 1993 [4] and first used in the laryngology field to examine the inner surface of the upper airway in 1996 [5]. Many studies have compared the reconstructed virtual images to fiberoptic bronchoscopy [4,[6][7][8][9], showing accurate renderings of the tracheobronchial system.…”

“…Virtual bronchoscopy was first described in 1993 [4] and first used in the laryngology field to examine the inner surface of the upper airway in 1996 [5]. Many studies have compared the reconstructed virtual images to fiberoptic bronchoscopy [4,[6][7][8][9], showing accurate renderings of the tracheobronchial system. It has been used by radiologists and head and neck oncologists for central airway imaging to provide an important complementary method of viewing central airway disorders [10] in the preplanning of complex diagnostic and therapeutic airway procedures [11][12][13][14][15] and has been shown to be useful for evaluation and follow-up of airway stenosis [4,[16][17][18].…”

“…Mark et al [4] commented on how costly and time consuming virtual bronchoscopy was, not because of the duration of the scan, but for the time taken to reconstruct the image and create run-through videos. Comparing this to the rapid nature of performing a fiberoptic bronchoscopy, this could be seen as a disadvantage [25,26].…”

A New Technique for the Examination of Tracheal Tumors

“…[3][4][5] However, virtual bronchoscopy cannot be used to view the surface structure of the tracheal lumen in detail. The bronchoscopic turned around procedure can provide a more detailed observation of mucosal lesions, such as tumors, in the distal end of the trachea.…”