Lost in Navigation: A Simplified CT-Based Airway Mapping Method for Ultrathin Navigational Bronchoscopy

Accurate navigation within the bronchial tree is essential for successful bronchoscopic sampling of peripheral pulmonary lesions. It fundamentally comprises a series of di/trichotomous decisions as the bronchoscope is advanced through sequential airway generations. This letter describes a simplified, pen-and-paper method for bronchial branch tracing that minimizes distracting complexity and streamlines airway mapping into reproducible steps that can be rapidly performed with reference to pre-procedural CT images. By anchoring navigation in anatomical recognition and spatial awareness, this technique offers both a reliable primary strategy and a dependable fallback option for bronchoscopists seeking clarity and confidence in the procedural suite.