Paradigmatic examples of the first four categories are shown in Figure 1. The visual inspection and the description of endoscopic findings were always the duty of at least two operators, who both signed the final report. For this study, only one type of abnormality (the most significant on the basis of the description-report) was considered for each patient. buy flovent inhaler
Bronchoscopic examinations were performed in a large, well-equipped biopsy room using the FB (Olympus BF1T10 or BFP10 or BF20). Patients who had no absolute contraindications to the procedure, such as severe bleeding diathesis, were premedicated with atropine after an overnight fast; topical anesthesia was accomplished with a rhino-oropharyngeal spray of a 4 percent solution of benoxinate (oxybuprocaine) hydrochloride (Novesine), followed by additional instillations of the same medication through a curved cannula and then through the suction channel of the same FB. The transnasal approach was used in nearly all patients. After a complete inspection of the visible tracheobronchial tree, samples were taken from areas that appeared to be abnormal. Any visible lesion was biopsied, by brush or forceps, through the channel of the instrument. In 25 cases, biopsies were obtained blindly from segments corresponding to radiologic opacities, since there were no endobronchial abnormalities.

Figure-1

Figure 1. Representative examples of tumor (top left), necrosis (top right), infiltration (bottom left), and compression (bottom right). See text for description.