Air-splinting Maneuver During Flexible Bronchoscopy A Cross-sectional Study

Magazine, Rahul and Chogtu, Bharti (2018) Air-splinting Maneuver During Flexible Bronchoscopy A Cross-sectional Study. Journal of Bronchology and Interventional Pulmonology, 25 (4). pp. 315-321. ISSN 1944-6586

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Abstract

Background: Magazine’s maneuver was developed for ease of insertion of the flexible bronchoscope, on encountering a closed lumen at the nasopharynx-oropharynx junction. The purposes of this study were to find the frequency of occurrence of such luminal closures and to compare the efficacy of Magazine’s maneuver, with other variations of the maneuver, in improving visualization of the upper airway.Materials and Methods: Patients aged 18 years and above who were undergoing flexible bronchoscopy were included, and their demographic and clinical data were noted. The bronchoscope was inserted using the transnasal approach, and, at the junction of nasopharynx with oropharynx, the patency of the lumen between the soft palate and the posterior pharyngeal wall was recorded. The subjects were instructed to perform 4 variations of the maneuver. Observations at each variation were recorded as lumen open or closed; if the lumen was open, the size was noted as small or large and whether it closed during expiration. Results: Among 443 subjects, obstruction at the nasopharynx- oropharynx junction was observed, at baseline, in 105 (23.7%); whereas 338 (76.3%) had an open lumen. An open lumen was observed during nose and mouth breathing in 294 (66.4%) subjects, and, when head-tilt chin-lift was added to it, it was observed in 303 (68.4%). During Magazine’s maneuver the lumen remained open in all 443 (100%) subjects. Half of the subjects (n=8) with body mass index >30 and onethird (n=29) above 65 years of age had luminal closure at baseline Conclusion: Magazine’s maneuver opens up the obstruction at the nasopharynx-oropharynx junction, whereas mouth and nose breathing mostly fails to do so Adding head-tilt chin-lift to either of the 2 breathing techniques does not provide any additional benefit.

Item Type: Article
Uncontrolled Keywords: Flexible bronchoscopy; Air-splinting maneuver; Nasopharynx; Oropharynx
Subjects: Medicine > KMC Manipal > Pharmacology
Medicine > KMC Manipal > Pulmonary Medicine
Depositing User: KMC Library
Date Deposited: 06 Oct 2018 04:38
Last Modified: 06 Oct 2018 04:38
URI: http://eprints.manipal.edu/id/eprint/152083

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