Pediatric respiratory medicine is a rapidly advancing field with pediatric airway endoscopy or bronchoscopy being a well-established procedure for both diagnostic and therapeutic purposes. Currently, interventional bronchoscopy in children is emerging as a new diagnostic and therapeutic tool in a wide variety of indications which were not possible earlier.
Advantage is that it is minimally invasive, cost-effective and time effective procedure. However, the limitation is that it is available in very few centres in the country due to lack of training and expertise.
Endobronchial and brush biopsy
In the above procedures a biopsy is taken under direct vision from the bronchial wall, or any abnormal or suspicious looking area and sent for microbiological and histopathological examination
This is a simple and easy method used to sample hilar and mediastinal lymph nodes in cases of suspected tuberculosis (especially when diagnosis is unclear or when resistant tuberculosis is suspected), malignancy or sarcoidosis. The enlarged lymph nodes are first diagnosed on CT (computerized tomography) of chest and then the site of sampling is localized. The advantage is that it is a less invasive method as compared to EBUS TBNA (Endobronchial ultrasound transbronchial needle aspiration)
Endobronchial ultrasound (EBUS) transbronchial needle aspiration (EBUS â€“ TBNA)
EBUS TBNA is similar to cTBNA in that it also involves sampling of enlarged lymph nodes in chest cavity in and around the airways or bronchi by penetrating a needle through the airway into the mass which is lying adjacent but outside the bronchus. The difference from cTBNA is that it is a highly precise and safe method as sampling is done by localizing the lymph node by using ultrasound ultrasound waves. Hence the yield of sample is good and it has a high sensitivity. Also, smaller sized glands can also be sampled. It is done under general anaesthesia. Usually, the pathologist is also called for the procedure and immediately processes the sample for adequacy and rapid diagnosis. This is called as ROSE or rapid on - site examination. Read More