THREE DIMENSIONAL VIRTUAL BRONCHOSCOPY IN CASES WITH AIRWAY PATHOLOGIES: AN EARLY EXPERIENCE FROM A TERTIARY CARE CENTER OF NEPAL

Abstract

Objective: To evaluate the findings of the airway in virtual 3D bronchoscopy and to compare it with the findings on laryngotracheal evaluation (LTE) or rigid bronchoscopy in patients with suspected airway pathology and also to evaluate the added benefits of incorporating virtual 3D bronchoscopy in airway surgery practice.

Materials & Methods: This was a prospective observational study conducted in the Department of ENT-Head and Neck Surgery of T.U. Teaching Hospital, Nepal from December 2018 to December 2019. Cases presenting with laryngotracheal obstruction resulting from stenosis, malacia, foreign body(FB) or any congenital pathologies with a multidetector computed tomography scan done for the concerning pathology were included in the study. Cases without CT scan done or without the readable Digital Imaging and Communication in Medicine (DICOM) files for 3D reconstruction were excluded from the study. Three-dimensional bronchoscopy was performed by the author. We used M.S. excel to record the data.

Results:
A total of seven cases were evaluated. Three-dimensional bronchoscopy revealed pathologies (FB in two cases and airway stenosis in three cases) in five cases which was similar to the findings in rigid bronchoscopy and LTE. Two cases with suspected aspiration hadno pathologies detected on 3D bronchoscopy as well as on rigid bronchoscopy.

Conclusion: Virtual 3D bronchoscopy is a very helpful tool in diagnosing airway pathologies especially in children and can be a good alternative to the diagnostic rigid bronchoscopy and endoscopic LTEwhen intervention is not required.

Keywords: Airway, bronchoscopy, Three dimensional, Virtual