Fiberoptic bronchoscopy in the upper airway

Background: The aim of the study is to assess the utility of fiberoptic bronchoscopy (FBC) in upper airway (UA) lesions. Methods: Retrospective analysis of all FBC performed for diagnostic and therapeutic purposes in patients with injuries of the UA, in Valme hospital from January 2015 to December 2016. Results: It includes 126 patients referred from the Otolaryngology (ORL) service, 13 women and 113 men, with an average age of 61.5 (11.6) years. In 7 cases (5.6%) the reason for the FBC was an extraction of foreign body located in the highways; in 20 (15.9%) it was oncological control or visualization of known alterations and in the remaining 99 (78.6%) it was a biopsy for anatomical laryngeal injuries detected by ORL. They were referred for laryngeal microsurgery due to the discordance between the endoscopic findings and anatomopathological results in 28 patients (22.2%), 13 were diagnosed with an epidermoid carcinoma. The sensitivity for the diagnosis of neoplasia was 78%, the specificity was 100%, the value positive predictive was 100% and the negative predictive value was 53%. The most frequent macroscopic findings were direct signs of neoplasia in 59 patients (47%), among the ones, the diagnosis of squamous carcinoma was confirmed in 43 and lymphoma for 1. Conclusions: The FBC can be considered as a prime choice for patients with UA lesions, due to its high diagnostic profitability, an early diagnosis and economic saving consistent with what implies performing a microsurgery.