Bronchial tuberculosis, as the name implies, is tuberculosis that occurs in the trachea or bronchial region. The diagnosis of tracheal and bronchial tuberculosis relies mainly on tracheoscopy to confirm the diagnosis. What is directly observed from tracheoscopy is the invasion of the tracheal and bronchial mucosa, so it is generally called endobronchial tuberculosis. However, in recent years, it has been found that the lesion is often not limited to the mucosal layer of the bronchus, and if treatment is not timely, the lesion can develop further down to the submucosa, muscular layer, cartilage, and even to the outer mucosa, so the diagnostic name of endobronchial tuberculosis seems to be inaccurate, so it is called bronchial tuberculosis instead. The incidence of bronchial tuberculosis has not been investigated in accordance with epidemiological requirements. It is limited to the statistics of some authors on patients in a particular hospital. In the early 1950s, it was reported that tracheoscopic examination of more than 400 children with tuberculosis revealed that nearly 40% of the children also had bronchial tuberculosis. Doctors in China who have been performing bronchoscopy for years agree that before the 1990s, there were not as many patients with tuberculosis in China who had combined bronchial tuberculosis as was reported abroad. Unfortunately, no specific statistics are available. In contrast, there has been a significant increase in the number of TB patients with combined bronchial tuberculosis in the last decade. Again, there are still no accurate statistics. However, not only tuberculists, but also respiratory physicians, share the feeling that the number of patients with bronchial tuberculosis has increased significantly. In addition, there are some new changes in the clinical presentation of bronchial tuberculosis. For example: 1. Many physicians have identified patients who have no obvious intrapulmonary TB lesions, but whose tracheal and bronchial TB is very extensive and severe. 2. Previously, bronchial tuberculosis was mainly infiltration of the mucosa, which showed more congestion and edema, erosion and ulceration of the mucosa, and some patients showed a small amount of granulation. At present, there is an obvious trend of increasing the number of patients showing mainly granulomatous and fibrous hyperplasia. In some patients, although the trauma of bronchial tuberculosis has healed, the stenosis of bronchial lumen caused by the proliferation of fibrous connective tissue and local scar contraction at the lesion site has also increased significantly. Due to the narrowing of the bronchial lumen, the absorption of the lesion in the lung on the terminal side is affected in most cases, which naturally prolongs the treatment period and affects the treatment effect. In more severe cases, complete atresia of one side of the common bronchus or lobe or segmental bronchus even occurs. This causes complete atelectasis of one whole lung or related lobe or segment of lung. 4. There is also an increase in the number of patients with damaged trachea and bronchial cartilage. Patients with clinical softening of the trachea and bronchi are also often seen. For patients who present with bronchial stenosis, it is relatively rare clinically, and misdiagnosis is more common. I once encountered a patient who had been misdiagnosed for nearly 2 years in clinical practice. He was misdiagnosed as having bronchial asthma because of shortness of breath after activity and a more pronounced whistling sound when breathing due to airway stenosis. Others have been over-treated because of narrowing of the bronchi, difficulty in expelling sputum distally, and increased shadows in the lungs on chest radiographs, which were misdiagnosed as worsening intrapulmonary lesions. Others require frequent anti-inflammatory treatment because of bronchial stenosis, difficulty in sputum expulsion, and recurrent combined bacterial infections on the terminal side. In a significant number of such patients, the improvement of bronchial stenosis is followed by improvement of ventilation, and the phenomenon of shortness of breath, pulmonary atelectasis or shadowing on the terminal side also appears to be significantly better after the smoother discharge of stagnant sputum. Diagnosis and treatment of bronchial tuberculosis is naturally on the agenda. The diagnosis of bronchial tuberculosis is not a new topic and relies mainly on bronchoscopy to confirm the diagnosis. Of course, at present, CT examination, especially the application of 3D imaging technology of CT, can also observe the rough and unsmooth inner wall of trachea and bronchus, thus drawing the doctor’s attention. However, bronchoscopy is still required to confirm the diagnosis. It is important to emphasize that since bronchoscopy cannot be performed on all TB patients, how can we screen out those patients with bronchial TB? In other words, which patients should be mobilized to undergo bronchoscopy? So that they can be diagnosed and treated as early as possible. In this way, we can minimize the occurrence of bronchial stenosis and prevent the development of atelectasis. The indications for bronchoscopy are: 1. Rough and unsmooth tracheal or bronchial walls or stenosis of lobar or segmental bronchi on CT or CT 3D imaging. 2.Patients with severe cough or anti-tuberculosis treatment for more than 1 month, but the cough still does not show significant improvement. 3.Those who have limited focal emphysema or poor ventilation or pulmonary atelectasis on chest X-ray. 4, Those who have increased and increased shadows in the affected lung during the course of anti-tuberculosis treatment. 5.Shortness of breath and shortness of breath that does not correspond to the extent of the lesion in the lung after activity. All of the above are recommended indications for examination. Regarding the treatment, most of the literature reports that the group treated with bronchoscopy, removal of necrotic material and local injection of anti-tuberculosis drugs is better than the control group without local treatment in terms of cough and other symptoms, as well as in terms of healing time of the lesion and prevention of bronchial stenosis. Theoretically, if an appropriate amount of dressing agent is added to the injectable anti-tuberculosis drugs during endobronchial administration to prolong the local action of anti-tuberculosis drugs, the treatment effect may be further improved. However, there is no evidence-based medical evidence yet. For patients who have developed significant tracheal or bronchial stenosis, most domestic experts from one to another currently believe that balloon dilation is the first recommended treatment, and that very satisfactory results can be achieved in more than 80% of patients. Unless there is significant tracheal softening, try not to use stents for treatment. If stents must be placed, they should be removed within 2-3 months of placement if possible. In cases where the terminal side of the lung has been significantly destroyed, lung function cannot be restored even if the stenosis is dilated, as there is no practical significance. It is recommended not to use dilatation therapy and to proceed directly to surgical treatment. In cases where treatment is not timely and the bronchial orifice is completely closed, it is thought that the bronchial lumen can be opened first and then dilated. Because of the extremely high risk. This method should never be used without CT localization and subtracheal “B” ultrasound guidance. Currently, only surgical treatment is available for lobes or whole lungs that are completely atretic. If the patient is concerned, he can be temporarily observed for a period of time, but in case of abnormalities he should be mobilized for surgical treatment. Bronchial tuberculosis should be classified as extra-pulmonary tuberculosis according to the currently implemented tuberculosis classification criteria. Therefore, the duration of treatment has become a special concern for every doctor. I personally recommend that the duration of treatment be at least six to nine months of regular anti-tuberculosis treatment when the bronchial lesions are no longer showing signs of active tuberculosis, or when the dilatation treatment is finished. This is, of course, my personal recommendation. I also hope that tuberculosis doctors nationwide will join me in a controlled study. In order to find a reasonable period of treatment. In conclusion, the problem of bronchial tuberculosis is a subject before every tuberculist, and I am writing today on this small topic in the hope of drawing the attention of tuberculists so that every patient with bronchial tuberculosis can receive early, adequate, and reasonable treatment.