Fiberoptic bronchoscopy for refractory cough

Area of Science:

• Pulmonology
• Diagnostic Imaging
• Respiratory Medicine

Background:

• Fiberoptic bronchoscopy (FB) has historically shown a low diagnostic yield for unselected chronic cough cases.
• Refractory chronic cough presents a diagnostic challenge, often requiring advanced investigations.

Purpose of the Study:

• To evaluate the diagnostic yield of FB for chronic cough in patients with nonlocalizing chest roentgenograms who failed other diagnostic efforts.
• To identify predictors of positive FB findings in this specific patient cohort.

Main Methods:

• A retrospective analysis of 25 patients undergoing FB for chronic cough over a four-year period.
• Inclusion criteria: nonlocalizing chest roentgenograms, refractory cough, and failure of empiric therapies.
• Analysis of diagnostic findings and patient demographics, including age, sex, and cough duration.

Main Results:

• FB yielded a diagnosis in 7 (28%) of 25 patients.
• Specific diagnoses included broncholithiasis, tracheobronchopathia osteochondroplastica, tuberculous bronchostenosis, laryngeal dyskinesia, and arytenoid polyp.
• Older age (>50 years) and female sex were independent predictors of positive findings (p=0.02).
• No tracheobronchial neoplasms were detected.

Conclusions:

• Fiberoptic bronchoscopy offers a respectable diagnostic yield for carefully selected patients with refractory chronic cough and nonlocalizing chest roentgenograms.
• The procedure is a reasonable diagnostic tool when other methods have failed, particularly in older female patients.