The Project Gutenberg eBook, Bronchoscopy and Esophagoscopy, by Chevalier Jackson

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Title: Bronchoscopy and Esophagoscopy A Manual of Peroral Endoscopy and Laryngeal Surgery

Author: Chevalier Jackson

Release Date: September 13, 2006 [eBook #19261]

Language: English

Character set encoding: ISO-646-US (US-ASCII)

***START OF THE PROJECT GUTENBERG EBOOK BRONCHOSCOPY AND ESOPHAGOSCOPY***

This book is one of the pioneering works in laryngology. The original text is from the library of Indiana University Department of Otolaryngology-Head and Neck Surgery, Bruce Matt, MD. It was scanned, converted to text, and proofed by Alex Tawadros.

BRONCHOSCOPY AND ESOPHAGOSCOPY

A Manual of Peroral Endoscopy and Laryngeal Surgery

by

CHEVALIER JACKSON, M.D., F.A.C.S.
Professor of Laryngology, Jefferson Medical College, Philadelphia;
Professor of Bronchoscopy and Esophagoscopy, Graduate School of
Medicine, University of Pennsylvania; Member of the American
Laryngological Association; Member of the Laryngological,
Rhinological, and Otological Society; Member of the American Academy
of Ophthalmology and Oto-Laryngology; Member of the American
Bronchoscopic Society; Member of the American Philosophical Society;
etc., etc.

With 114 Illustrations and Four Color Plates

Philadelphia And London
W. B. Saunders Company
1922
Copyrights 1922, by W. B. Saunders Company
Made in U.S.A.

TO MY MOTHER TO WHOSE INTEREST IN MEDICAL SCIENCE THE AUTHOR OWES HIS INCENTIVE, AND TO MY FATHER WHOSE CONSTANT ADVICE TO "EDUCATE THE EYE AND THE FINGERS" SPURRED THE AUTHOR TO CONTINUAL EFFORT, THIS BOOK IS AFFECTIONATELY DEDICATED.

PREFACE

This book is based on an abstract of the author's larger work, Peroral Endoscopy and Laryngeal Surgery. The abstract was prepared under the author's direction by a reader, in order to get a reader's point of view on the presentation of the subject in the earlier book. With this abstract as a starting point, the author has endeavored, so far as lay within his limited abilities, to accomplish the difficult task of presenting by written word the various purely manual endoscopic procedures. The large number of corrections and revisions found necessary has confirmed the wisdom of the plan of getting the reader's point of view; and these revisions, together with numerous additions, have brought the treatment of the subject up to date so far as is possible within the limits of a working manual. Acknowledgment is due the personnel of the W. B. Saunders Company for kindly help.

CHEVALIER JACKSON. OCTOBER, 1922. II

CONTENTS PAGE

CHAPTER I INSTRUMENTARIUM 17 CHAPTER II ANATOMY OF LARYNX, TRACHEA, BRONCHI AND ESOPHAGUS, ENDOSCOPICALLY CONSIDERED 52 CHAPTER III PREPARATION OF THE PATIENT FOR PERORAL ENDOSCOPY 63 CHAPTER IV ANESTHESIA FOR PERORAL ENDOSCOPY 65 CHAPTER V BRONCHOSCOPIC OXYGEN INSUFFLATION 71 CHAPTER VI POSITION OF THE PATIENT FOR PERORAl ENDOSCOPY 73 CHAPTER VII DIRECT LARYNGOSCOPY 82 CHAPTER VIII DIRECT LARYNGOSCOPY (Continued) 91 CHAPTER IX INTRODUCTION OF THE BRONCHOSCOPE 97 CHAPTER X INTRODUCTION OF THE ESOPHAGOSCOPE 106 CHAPTER XI ACQUIRING SKILL 117 CHAPTER XII FOREIGN BODIES IN THE AIR AND FOOD PASSAGES 126 CHAPTER XIII FOREIGN BODIES IN THE LARYNX AND TRACHEOBRONCHIAL TREE 149 CHAPTER XIV REMOVAL OF FOREIGN BODIES FROM THE LARYNX 156 CHAPTER XV MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION 158 CHAPTER XVI FOREIGN BODIES IN THE BRONCHI FOR PROLONGED PERIODS 177 CHAPTER XVII UNSUCCESSFUL BRONCHOSCOPY FOR FOREIGN BODIES 181 CHAPTER XVIII FOREIGN BODIES IN THE ESOPHAGUS 183 CHAPTER XIX ESOPHAGOSCOPY FOR FOREIGN BODY 187 CHAPTER XX PLEUROSCOPY 199 CHAPTER XXI BENIGN GROWTHS IN THE LARYNX 201 CHAPTER XXII BENIGN GROWTHS IN THE LARYNX (Continued) 203 CHAPTER XXIII BENIGN GROWTHS PRIMARY IN THE TRACHEOBRONCHIAL TREE 207 CHAPTER XXIV BENIGN NEOPLASMS OF THE ESOPHAGUS 209 CHAPTER XXV ENDOSCOPY IN MALIGNANT DISEASE OF THE LARYNX 210 CHAPTER XXVI BRONCHOSCOPY IN MALIGNANT GROWTHS OF THE TRACHEA 214 CHAPTER XXVII MALIGNANT DISEASE OF THE ESOPHAGUS 216 CHAPTER XXVIII DIRECT LARYNGOSCOPY IN DISEASES OF THE LARYNX 221 CHAPTER XXIX BRONCHOSCOPY IN DISEASES OF THE TRACHEA AND BRONCHI 224 CHAPTER XXX DISEASES OF THE ESOPHAGUS 235 CHAPTER XXXI DISEASES OF THE ESOPHAGUS (Continued) 245 CHAPTER XXXII DISEASES OF THE ESOPHAGUS (Continued) 251 CHAPTER XXXIII DISEASES OF THE ESOPHAGUS (Continued) 260 CHAPTER XXXIV DISEASES OF THE ESOPHAGUS (Continued) 268 CHAPTER XXXV GASTROSCOPY 273 CHAPTER XXXVI ACUTE STENOSIS OF THE LARYNX 277 CHAPTER XXXVII TRACHEOTOMY 279 CHAPTER XXXVIII CHRONIC STENOSIS OF THE LARYNX AND TRACHEA 300 CHAPTER XXXIX DECANNULATION AFTER CURE OF LARYNGEAL STENOSIS 309 BIBLIOGRAPHY 311 INDEX 315

[17] CHAPTER I—INSTRUMENTARIUM

Direct laryngoscopy, bronchoscopy, esophagoscopy and gastroscopy are procedures in which the lower air and food passages are inspected and treated by the aid of electrically lighted tubes which serve as specula to manipulate obstructing tissues out of the way and to bring others into the line of direct vision. Illumination is supplied by a small tungsten-filamented, electric, "cold" lamp situated at the distal extremity of the instrument in a special groove which protects it from any possible injury during the introduction of instruments through the tube. The bronchi and the esophagus will not allow dilatation beyond their normal caliber; therefore, it is necessary to have tubes of the sizes to fit these passages at various developmental ages. Rupture or even over-distention of a bronchus or of the thoracic esophagus is almost invariably fatal. The armamentarium of the endoscopist must be complete, for it is rarely possible to substitute, or to improvise makeshifts, while the