EXCISION OF BRONCHOGENIC CYSTS IN CHILDREN USING AN ULTRATHIN FIBEROPTIC BRONCHOSCOPE

Purpose: We report the use Of air ultrathin fibreoptic bronchoscope (O lympus N20: external diameter: 2.2 mm) as the means of airway endoscop ic monitoring during anaesthesia for rite excision of mediastinal bron chogenic cysts in two young children. Clinical features: The first, a four-month old boy, presented with stridor and wheezing due to a subca rinal bronchogenic cyst compressing the two main bronchi. The second, an eight-day-old girl whose trachea was intubated, presented with resp iratory noise in relation to a bronchogenic cyst compressing the end o f the trachea. In both cases, airway endoscopy was performed during ar ?aesthesia with the ultra thin fibreoptic bronchoscope. Endoscopic mon itoring allowed, first, a good evaluation of tire degree of cyst compr ession on the airways. Second, the endotracheal tube could be position ed or repositioned with precision in order to avoid severe compression or spilling of liquid into the airways and to allow protection of the suture. Finally video transmission helped the surgeon to visualize th e surgical repair from the inside. Conclusion: When added to the class ical monitoring using SpO(2), PETCO(2) and airway pressure, peroperati ve endoscopic control provides complementary information which can hel p to detect possible complications more rapidly This technique could b e extended to all airway surgery on very young children.