• 대한치과마취과학회지
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• 제12권2호
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• pp.121-123
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• 2012

Nasotracheal intubation is an essential procedure during general anesthesia for dental treatment. Fiberoptic intubation is best accomplished by those who perform it as part of their daily practice. But nasal approach of fiberoptic intubation has some complications such as epistaxis and laryngeal injury. Especially, epistaxis is common and it make fiberoptic intubation because of limited view. When the epistaxis obstruct the field of vision we have to withdraw the fiberoptic bronchoscope and consider the other method for securing the airway. We succeeded in securing the airway of patient who had epistaxis during the fiberoptic nasotracheal intubation without withdrawing the fiberoptic bronchoscope. We used blind intubation guided by light source placed the tip of fiberoptic bronchscope applied to lightwand intubation.

• Tuberculosis and Respiratory Diseases
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• 제77권6호
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• pp.251-257
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• 2014

Background: Transbronchial lung biopsy (TBLB) is a valuable diagnostic tool for peripheral pulmonary lesions. The diagnostic yield of TBLB reportedly ranges from 41%-60%. Many studies demonstrated the various factors that influence the yield of TBLB, including size, location, and distance from the carina or pleura. However, no study has evaluated the effects of the bronchoscope diameter. We evaluated whether the bronchoscope diameter affected the diagnostic yield of TBLB. Methods: We reviewed records from 178 patients who underwent TBLB using bronchoscopes of two different diameters (5.7 mm, thick outer diameter, Olympus BF-200; 4.9 mm, thin, BF-260). The fluoroscopic guidance rates, yield of TBLB and flexible bronchoscopy (FB) were compared between the two groups. Additionally, we compared the results of the procedures with respect to diagnosis, distance from the pleura, and size of the lesion. Results: The results of fluoroscopic guidance, TBLB, and FB yield using thin diameter bronchoscope were significantly better than those obtained with a thick diameter bronchoscope (p=0.021, p=0.036, and p=0.010, respectively). Particularly, when the distance from the pleura was ${\leq}10mm$, success rates for fluoroscopic guidance and FB with thin bronchoscope were higher (p=0.013 and p=0.033, respectively), as compared to with thick bronchoscope. Conclusion: A thinner diameter bronchoscope increased the yield of bronchoscopy, and bronchial washing in conjunction with TBLB was useful in the diagnosis of peripheral pulmonary nodules.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.37-41
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• 2022

Airway foreign body aspiration in children can lead to accidental death, due to the foreign body itself or the removal procedure. Depending on its location, removal of the foreign body can be challenging. Here, we present a case of successful removal of a foreign body from the left upper lobar bronchus via ventilating bronchoscopy with a rigid bronchoscope and Fogarty arterial embolectomy catheter. Tracheobronchial foreign bodies in locations that are difficult to reach with forceps, due to an acute angle or the small diameter of the pediatric bronchial tree, can be effectively removed with a Fogarty arterial embolectomy catheter.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.167-171
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• 2015

When anesthesiologists encounter conditions in which intubation is not possible using a conventional direct laryngoscope, they can consider using other available techniques and devices such as fiber optic bronchoscope (FOB)-guided intubation, a laryngeal mask airway (LMA), intubating LMA (ILMA), a light wand, and the Combitube. FOB-guided intubation is frequently utilized in predicted difficult airway cases and is generally performed when the patient is awake to enable easier access to the trachea. An LMA can be introduced to ventilate the patient with relative ease, while an ILMA can be used for definite endotracheal intubation. However, occasionally, an endotracheal tube (ETT) cannot pass through the larynx, despite successful introduction of a FOB into the trachea and placement of an ILMA by the anesthesiologist. Therefore, we initially introduced an ILMA for emergent ventilation, followed by successful insertion of an ETT under FOB guidance. In this report, we describe three cases of difficult intubation using a FOB and ILMA combination approach.

• 대한세포병리학회지
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• 제16권1호
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• pp.36-40
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• 2005

The mucoepidermoid carcinoma is a rare tumor in the lung for less than 1% of all pulmonary neoplasm. It is mostly presented as a solitary pulmonary nodule at a large bronchial tree on bronchoscope. But more peripheral located tumor that not accessible to the bronchoscope are rarely reported on literature. The cytologic findings of these tumors are discribed as a mixture of squamous cells, mucous cells, and intermediate cells with overlapped cellular clusters. We experienced a case of peripheral mucoepidermoid carcinoma of lung diagnosed by fine needle aspiration cytology. The smear showed many cellular clusters on mucoid background. They consisted of many intermediate cells with occasional mucus-secreting cells, but malignant squamous cells were not present.

• Tuberculosis and Respiratory Diseases
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• 제58권4호
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• pp.404-409
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• 2005

기관지흉막루는 수술적 치료를 고려해야 하나 대부분의 환자들이 전신상태가 불량하고 기저질환으로 인해 수술을 시행할 수 없는 경우가 많다. 이런 환자들에게 있어서 굴곡성 기관지내시경을 이용하여 누공을 폐쇄시키는 다양한 방법들이 시도되고 있다. 저자들은 폐렴 및 농흉이 동반된 고령의 환자에서 흉관삽입 후 발생한 원위부 기관지 흉막루를 굴곡성 기관지내시경을 이용한 EWS 삽입으로 치료에 성공한 1례가 있어 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.29-34
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• 1993

연구배경 : Ikeda에 의해 임상에 도입된 굴곡성 기관지경은 각종 폐 질환의 진단과 치료에 광범위하게 이용되고 있으며 시술 증례도 증가하고 있으나 외국에서는 결핵균, 비결핵항산균 및 여러 세균들에 의한 기관지경의 교차오염예가 다수 보고되고 있으므로 기관지경의 세척과 소독방법에 대해 주의를 기울여야 한다. 방법 : 1991년 11월부터 1992년 5월 까지 기관지내시경을 시행한 예중에서 기관지세척액에서 비결핵항산균이 배양된 예들을 분석하고 본원에서 화학살균제로 사용하고 있는 2% alkaline glutaraldehyde의 살균작용을 평가하기 위하여 실험실내에서 2% alkaline glutaraldehyde와 비결핵항산균 및 세균을 접촉시킨후 균의 사멸 여부를 알아 보았다. 결과 : 2% glutaraldehyde 소독제 용액에 비결핵항산균은 2% glutaraldehyde 1:1 용액으로 30분간 접촉한 후 균이 자라지 않았으며 그 밖의 세균들은 접촉 바로 후에 자라지 않았다. 위발생 인지후 철저한 기계적 세척과 함께 세척기내에서 30분이상 2% glutaraldehyde에 담가둔 이후로는 위양성이 발생하지 않았다. 결론 : 기관지경 사용후 기계적 세척을 철저히 하는 것이 중요하며 2% glutaraldehyde 용액으로 소독시 비결핵항산균의 소멸을 기대하려면 적어도 30분 이상 접촉이 필요할 것으로 생각된다. 또한 감염조절 방법을 엄격하게 적용한다 하더라도 오염을 완전히 배제할 수 없으므로, 일반적으로 비병원균으로 알려진 균들이 비통상적으로 갑자가 높은율로 검출되면 위발생을 생각하여야 한다.

• Tuberculosis and Respiratory Diseases
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• 제77권5호
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• pp.215-218
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• 2014

Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.219-223
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• 2017

In cases of multiple facial trauma and other specific cases, the anesthesiologist may be asked to convert an oral endotracheal tube to a nasal endotracheal tube or vice versa. Conventionally, the patient is simply extubated and the endotracheal tube is re-inserted along either the oral or nasal route. However, the task of airway management can become difficult due to surgical trauma or worsening of the airway condition. Fiberoptic bronchoscopy was considered a novel method of airway conversion but this method is not useful when there are secretions and bleeding in the airway, or if the anesthesiologist is inexperienced in using this device. We report a successful airway conversion under the aid of both, a fiberoptic bronchoscope and a C-MAC video laryngoscope.

• Medical Lasers
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• 제10권1호
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• pp.55-59
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• 2021

A foreign body in the airway can be a potentially life-threatening event. The diagnosis and treatment of foreign bodies in the airway are a challenge for otolaryngologists. Despite the improvements in medical care and public awareness, approximately 3,000 deaths occur each year from foreign body aspiration. A high degree of vigilance is required to ensure prompt treatment and avoid the complications of foreign body aspiration. The author encountered a case of a 77-year-old female patient who had aspirated an unknown foreign body that was fixed in her main bronchus. An initial attempt was made to remove it with a flexible bronchoscope but failed due to the patient's hypoxemic state during the procedure. Under general anesthesia, a rigid bronchoscopic examination was performed, but it was difficult to approach the object due to the bronchus curvature. Instead, a cryotherapy instrument of bronchoscopy was applied. The foreign body was frozen and removed to the carina, where a laryngoscope and laryngeal forceps were used to remove it.