الفهرس 
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Abstract
TEF and EA are congenital anomalies where there is an abnormal communication between the trachea and the esophagus.
It occurs in 1 in 2500–4500 live births. The primary types of congenital EA are EA with distal TEF, isolated EA without TEF, TEF without atresia or H-type TEF, EA with proximal TEF and EA with proximal and distal TEF.
EA /TEF is accompanied with other congenital abnormalities in about half of the cases. The type of EA determines the clinical presentation.
In cases of EA, a large-caliber nasogastric tube in the upper oesophagus is used in conjunction with a chest and abdomen x-ray to confirm the diagnosis. The value of preoperative bronchoscopy in EA is a major topic of dispute.
Coughing and cyanosis during feeding, recurrent pneumonia, and intermittent abdominal distension are all symptoms of isolated TEF in infants. For H-type fistula, a variety of diagnostic procedures are recommended. None of them, however, are extremely reliable.
Despite advances in surgical methods, a significant number of children develop acute and long-term respiratory problems.
The aim of this study was to reveal the role of flexible bronchoscopy in the assessment of postoperative persistent respiratory symptoms in cases of tracheoesophageal fistula.
This quasi-experimental study was carried out on 214 cases with congenital EA and/or TEF who presented to Alexandria university children’s hospital during the period from 1st of October 2015 to 1st of November 2020.
As regards cases of EA, the most common pulmonary symptoms were recurrent chest infections, persistent barking cough, persistent stridor, frequent aspiration and rattling. Recurrent respiratory infections were seen in up to 62.5% of patients with persistent symptoms. The main bronchoscopic findings were variable degrees of tracheomalacia, laryngeal cleft and laryngomalacia.
FFB showed evidence of TEF in cases suspected to have H-type TEF confirmed by passage of a guide wire through the fistula. One case had esophagogram showing TEF prior to FFB.
Flexible bronchoscopy has a pivotal role in the diagnosis of laryngotracheal anomalies in cases of EA and/or TEF after surgical repair and should be done also pre-operatively. As regards cases of H-type fistula, Flexible bronchoscopy is an excellent tool for diagnosis.