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Fiberoptic bronchoscopy for refractory cough.

R P Sen1, T E Walsh

  • 1Department of Internal Medicine, National Naval Medical Center, Bethesda.

Chest
|January 1, 1991
PubMed
Summary
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Fiberoptic bronchoscopy (FB) can diagnose refractory chronic cough in carefully selected patients. This study found a 28% diagnostic yield in patients with negative chest X-rays, identifying conditions like broncholithiasis and tuberculous bronchostenosis.

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.

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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.