What is bronchoscopy?
Bronchoscopy is a minimally invasive procedure to look directly at the airways in the lungs using a thin, lighted tube (bronchoscope) which is typically inserted through the nose or mouth and then guided down into the respiratory tract.
A doctor can then see the voice box (larynx), trachea, large airways to the lungs (bronchi), and smaller branches of the bronchi (bronchioles).
How to Prepare for the Test
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Not to eat or drink anything for 6 to 12 hours before your test.
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Not to take aspirin, ibuprofen, or other blood-thinning drugs before your procedure.
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Arrange for a ride to and from the hospital.
Why might I need bronchoscopy?
A bronchoscopy may be done to diagnose and treat lung problems such as:
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Tumors or bronchial cancer
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Airway blockage (obstruction)
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Narrowed areas in airways (strictures)
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Inflammation and infections such as tuberculosis (TB), pneumonia, and fungal or parasitic lung infections
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Interstitial pulmonary disease
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Causes of persistent cough
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Causes of coughing up blood
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Spots seen on chest X-rays
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Vocal cord paralysis
Diagnostic procedures or treatments that are done with bronchoscopy include:
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Biopsy of tissue
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Collection of sputum
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Fluid put into the lungs and then removed (bronchoalveolar lavage or BAL) to diagnose lung disorders
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Removal of secretions, blood, mucus plugs, or growths (polyps) to clear airways
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Control of bleeding in the bronchi
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Removing foreign objects or other blockages
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Laser therapy or radiation treatment for bronchial tumors
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Placement of a small tube (stent) to keep an airway open (stent placement)
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Draining an area of pus (abscess)
How the Test is Performed
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You will likely get medicines through a vein (IV, or intravenously) to help you relax.
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A numbing drug (anesthetic) will be sprayed in your mouth and throat. If bronchoscopy is done through your nose, numbing jelly will be placed in the nostril the tube goes through.
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The scope is gently inserted. It will likely make you cough at first. The coughing will stop as the numbing drug begins to work.
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The performing doctor may send saline solution through the tube. This washes the lungs and allows your doctor to collect samples of lung cells, fluids, microbes and other materials inside the air sacs. This part of the procedure is called a lavage.
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Sometimes, tiny brushes, needles, or forceps may be passed through the bronchoscope to take very small tissue samples (biopsies) from your lungs.
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Sometimes ultrasound is used to see the lymph nodes and tissues around your airways, and small needles can be inserted there to obtain tissue and make certain diagnoses.
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At the end of the procedure, the scope is removed.
What are the risks of bronchoscopy?
All procedures have some risks. The risks of this procedure may include:
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Bleeding
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Infection
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Hole in the airway (bronchial perforation)
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Irritation of the airways (bronchospasm)
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Irritation of the vocal cords (laryngospasm)
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Air in the space between the lung covering (pleural space) that causes the lung to collapse (pneumothorax)