Cough occurs as a result of a complex of neurophysiological and mechanical interactions within the respiratory system, and as such its efficiency is vital to human homeostasis and well-being. However, it may also be an indicator of many respiratory illnesses. Cough characteristics vary with illnesses but some disorders such as structural airway disorders/malacia have very characteristic brassy cough qualities and bronchoscopic findings. In chronic wet cough and other forms of cough without defining audible properties, the bronchoscopic visual appearance of the airways and bronchoalveolar lavage (BAL) cytological and culture assessments allow for identification and confirmation of specific conditions and organisms. Bronchoscopy is not indicated in all chronic coughs but is necessary where the chronic cough is unresolving and wet, has otherwise atypical features, associated with radiological or underlying congenital or acquired immunodeficiency, or suggests aspiration disorders or a foreign body. In these circumstances, consideration should be given to performing a flexible fibre-optic bronchoscopy and BAL even when the levels of physiological dysfunction appear minor. In the research context, bronchoscopy and BAL for chronic cough are providing considerable insight into diagnoses, overlapping and concomitant diagnoses and disease mechanisms but the role of brush and tissue biopsy is yet to be fully elucidated. Research dealing with the interface between cough and bronchoscopically derived data needs to be extended in the paediatric setting as it potentially offers enhanced understanding and treatment options for many conditions. � 2010 by S. Karger AG. All rights reserved.
|Title of host publication||Paediatric Bronchoscopy|
|Place of Publication||Switzerland|
|Publisher||S Karger AG|
|Number of pages||9|
|Publication status||Published - 2010|