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Updated: Aug 16, 2026

Systematic Bronchoscopy: the Four Landmarks Approach
Published on: June 23, 2023
[Contribution of flexible bronchoscopy to the diagnosis of upper airway alterations]
J Figuerola Mulet1, B Osona Rodríguez de Torres, M Llull Ferretjans
1Unidad de Neumología Infantil, Servicio de Pediatría, Hospital Universitario Son Dureta, Palma de Mallorca, Spain. jfiguerola@hsd.es
Introduction:
Flexible bronchoscopy (FB) is becoming an increasingly common diagnostic and therapeutic technique and is currently an essential procedure in pediatric pulmonology departments. Because the procedure is easy to perform under sedation and topical anesthesia, avoiding surgery with general anesthesia, which is required for rigid bronchoscopy, it has allowed the use of airway endoscopy in infants and children to be increased and has reduced patient risks.
Objective:
To analyze the contribution of FB to the diagnosis of upper airway alterations and to characterize the frequency and type of upper airway anomalies.
Patients And Methods:
We retrospectively reviewed the FB performed in our center between January 1993 and March 2003 in children aged less than 14 years old.
Results:
A total of 456 FB were performed in 378 children. One hundred eleven FB (24.5 % of all endoscopies) were required for suspected upper airway anomalies and 55.8 % corresponded to stridor. Upper airway inspection revealed abnormality in 30.7 % (140 FB). There were no severe complications.
Conclusion:
FB is useful in the diagnosis of upper airway abnormalities. The main indication for FB is stridor and the most common abnormal finding of the upper airway is laryngomalacia.
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