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Updated: Jun 30, 2026

Systematic Bronchoscopy: the Four Landmarks Approach
Published on: June 23, 2023
Flexible bronchoscopy and interdisciplinary collaboration in pediatric large airway disease
Maulik B Shah1, John P Bent, Alfin G Vicencio
1Department of Otorhinolaryngology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States. maulikshahmd@gmail.com
Insights
A multidisciplinary pediatric airway team using flexible bronchoscopy significantly benefited 10 otolaryngology patients. This approach enhances the evaluation and treatment of complex pediatric airway conditions, improving patient care.
Area of Science:
- Pediatric Otolaryngology
- Pulmonology
- Flexible Bronchoscopy
Background:
- Complex pediatric airway issues require specialized evaluation.
- Flexible bronchoscopy offers diagnostic and therapeutic capabilities.
Purpose of the Study:
- To demonstrate the benefits of a multidisciplinary pediatric airway team.
- To highlight the utility of flexible bronchoscopy in otolaryngology.
Main Methods:
- A case series of 10 children with complex airway symptoms.
- Flexible bronchoscopy used for diagnostic and therapeutic interventions.
- Retrospective review of interdisciplinary management and flexible bronchoscopy outcomes.
Main Results:
- All 10 patients (100%) benefited from the multidisciplinary approach.
- Flexible bronchoscopy was successfully employed for various diagnostic and therapeutic purposes.
Conclusions:
- Flexible bronchoscopy has diverse applications in pediatric otolaryngology.
- An equipped airway team enhances patient care through flexible bronchoscopy.
Objective:
Demonstrate the benefits of a multidisciplinary pediatric airway team prepared to evaluate and treat otolaryngology patients with flexible bronchoscopy.
Design:
Case series.
Setting:
Tertiary, academic children's hospital.
Patients:
10 children (5 male, 5 female age range 2 months-16 years) presenting with complex symptoms potentially referable to large airways.
Intervention:
Flexible bronchoscopy for diagnostic (bronchoalveolar lavage, ciliary biopsy, assess ongoing surgical intervention, and rule in or rule out foreign body; N=6) or therapeutic (evacuate bronchial mucus plug, laser subglottis when patient has fused cervical spine, and distal instillation [fibrin glue for bronchopleural fistula and dornase alpha for plastic bronchitis]; N=4).
Main Outcome Measure:
Retrospectively ask if flexible bronchoscopy and interdisciplinary management improved patient care in these select otolaryngology cases.
Results:
10/10 patients benefited from interdisciplinary management including flexible bronchoscopy.
Conclusion:
Our experience illustrates many uses for flexible bronchoscopy in otolaryngology patients, and suggests that an airway team prepared to use flexible bronchoscopy will create opportunities for improved patient care.
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