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Aero-digestive Endoscopy

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  1. Aero-digestive Endoscopy Dr. Vishal Sharma

  2. History

  3. Bozzini (1806): angled speculum with mirror using wax candle, first examined larynx • Manuel Garcia (1854): Using dental mirror, hand mirror & sunlight visualized his own vocal cords • Adolph Kussmaul (1868): 1st rigid esophagoscopy • Gustav Killian (1897): 1st rigid bronchoscopy • Chevalier Jackson (early 1900s): father of modern rigid endoscopy • Oscar Kleinsasser (1960): suspension micro-laryngoscope • Shigeto Ikeda (1966): first fiberoptic bronchoscopy & oesophagoscopy • H.H. Hopkins: rigid fiberoptic telescopes

  4. Adolph Kussmaul

  5. Gustav Killian

  6. Chevalier Jackson

  7. Shigeto Ikeda

  8. Direct Laryngoscopy

  9. Chevalier Jackson’s Direct Laryngoscope

  10. Anterior commissure Direct Laryngoscope

  11. Boyce’s Endoscopy position Supine position with head elevated by 10 cm

  12. Tongue Base visualized

  13. Epiglottis visualized

  14. Vocal cords visualized

  15. Micro-laryngoscopy

  16. Kleinsasser Microlaryngoscope

  17. Chest Piece

  18. Laryngoscope fixed

  19. Microscope focused

  20. Indications for Laryngoscopy

  21. Diagnostic Therapeutic  Biopsy of suspected malignancy  Foreign body in larynx & pyriform fossa removal (larynx & pyriform fossa)  Examination of hidden areas:  Excision biopsy anterior commissure, laryngeal of benign ventricle, subglottis, infrahyoid laryngeal lesion epiglottis, pyriform fossa apex  Dilatation of laryngeal stricture  Unsuccessful indirect laryngoscopy

  22. Rigid Bronchoscopy

  23. Rigid Bronchoscope

  24. Close-up of proximal end

  25. Bronchoscope introduced

  26. At laryngeal inlet

  27. Epiglottis identified

  28. Vocal cords identified

  29. Scope passed through glottis after 900 rotation

  30. Scope rotated back

  31. Tracheal rings identified

  32. Carina identified

  33. Bronchopulmonary segments

  34. Endoscopy position

  35. Scope in Right bronchus

  36. Scope in Right bronchus

  37. Scope in Right bronchus

  38. Scope in Left bronchus

  39. Scope in Left bronchus

  40. Scope in Left bronchus

  41. Flexible Bronchoscope

  42. Indications for Bronchoscopy • Broncho-alveolar lavage for C/S, AFB, cytology • Biopsy of tracheo-bronchial tumours • Investigation of chronic cough, hemoptysis, Lt vocal cord palsy, atelectasis, obstructive emphysema, mediastinal growths • Removal tracheo-bronchial of foreign bodies • Removal of retained respiratory secretions

  43. Rigid Oesophagoscopy

  44. Rigid Oesophagoscope

  45. Epiglottis visualized

  46. Right pyriform fossa

  47. Cricopharyngeal sphincter