[Value of tracheobronchial endoscopy in facial burns]

41 patients suffering from facial burns had a systematic tracheo-bronchial endoscopy in the 24 hours after admission to hospital. There were 21 cases of explosion (town gas or explosives), 11 burns from flames (petrol) and 9 burns occurring during fires (in houses or cars). 12 patients showed isolated mucosal inflammation, 5 blackish deposits (of impacted soot) and blisters in 6 (with shreds of mucosa hanging loose); the endoscopy was normal in 18; 66% of those with blisters (4 cases out of 6) and 40% with blackened mucosa (2 cases out of 5) were observed in burns from fires. The 18 patients without endobronchial lesions and 12 patients with only mucosal inflammation did not develop respiratory complications; 5 patients presenting with blackish deposits later develop complications and 4 out of 6 patients presenting with extensive blistering died from these respiratory complications. A study of the evolution of the lesions, as far as could be ascertained from several cases enabled the rules of local therapy to be set in such patients: aspiration and unblocking of the airways by repeated aspiration and lavage. In conclusion, the frequency of tracheo-bronchial lesions and their significance when planning therapy and their consequences on the prognosis justify tracheo-bronchial endoscopy to be used routinely in burns to the face.