TRADE-OFF BETWEEN AIRWAY-RESISTANCE AND OPTICAL RESOLUTION IN PEDIATRIC RIGID BRONCHOSCOPY

Contemporary pediatric rigid bronchoscopy reflects the culmination of years of work by prominent endoscopists aided by technical development s in optical physics and refinements in optical lens manufacturing. Im proved neonatal and pediatric care has allowed survival of premature i nfants, many with bronchopulmonary diseases. Rigid bronchoscopy in the se infants is demanding and has necessitated the development of miniat urized telescopic bronchoscopes. This study documents airway pressures through bronchoscopes with and without endoscopic telescopes, analyze s and quantitates optical resolution, discusses the tradeoffs between these instruments in airway resistance and optical resolution, and mak es recommendations regarding which combinations of endoscopes and bron choscopes provide the best resistance and resolution profiles. We conc lude that the size 1.9-mm endoscopic telescope provides the most favor able resistance and resolution profile for the size 2.5 to 3.0 broncho scopes, the 2.8-mm telescope is ideal for the 3.5 bronchoscope, and th e 4.0-mm telescope works best with the 4.0 and larger bronchoscopes. F urthermore, optical forceps and side-channel forceps used during bronc hial foreign body removal cause little change in airway resistance.