Current status of fibreoptic bronchoscopy.

The flexible fibreoptic bronchoscope was first made commercially available in 1970 (Anderson and Faber, 1978) and it has since had a major impact on the diagnosis and management ofpulmonary disease. Within 3 years of its introduction, 25,000 bronchofibrescopic examinations had been performed in the United States in 191 centres (Sackner, 1975). At the Brompton Hospital an average of 855 fibreoptic bronchoscopies have been performed annually since 1975. An earlier analysis of 1,223 of these showed that in most (81%), a histological diagnosis was made and no further diagnostic procedure was required (Mitchell et al., 1980). Following suitable preparation and pre-medication the fibrescope is normally passed through the nose under local anaesthesia; if the nasal passages cannot be negotiated it is passed through the mouth (Knight, 1981). Diagnostic indications for fibreoptic bronchoscopy include: (1) Possible endobronchial lesions. (2) Peripheral lung lesions. (3) Collection of samples for microbiological examination. (4) Diffuse lung disease of unknown aetiology.