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Alternative namesFiberoptic bronchoscopy
DefinitionBronchoscopy is a diagnostic procedure in which a tube with a tiny camera on the end is inserted through the nose or mouth into the lungs. The procedure provides a view of the airways of the lung and allows doctors to collect lung secretions or tissue specimens (biopsy).
How the test is performed
The pulmonologist (a lung specialist trained to perform a bronchoscopy) sprays a topical or local anesthetic in your mouth and throat. This will cause coughing at first, which will stop as the anesthetic begins to work. When the area feels "thick," it is sufficiently numb. Medications may be given through an IV to help you relax.
Usually, a flexible bronchoscope is used. The flexible tube is less than 1/2-inch wide and about 2 feet long. As the bronchoscope is used to examine the airways of the lungs, your doctor will obtain samples of your lung secretions to send for laboratory analysis.
Saline solution is introduced to flush the area and collect cells to be analyzed by a pathologist or microbiologist. This part of the procedure is called a "lavage" or a bronchial washing. Usually, small amounts (5-10 cc, or 1-2 teaspoons) of saline are used.
In certain circumstances, a larger volume of saline may be used. In this procedure, called bronchoalveolar lavage, up to 300 cc of saline (20 tablespoons) are instilled into the airway after the bronchoscope has been advanced as far as possible and a small airway is temporarily blocked by the scope. Bronchoalveolar lavage is performed to obtain a sample of the cells, fluids, and other materials present in the very small alveoli (air sacs).
In addition, tiny brushes, needles, or forceps may be introduced through the bronchoscope to obtain tissue samples from your lungs. Occasionally, stenting and laser therapies can be performed through the bronchoscope. A rigid bronchoscope is less commonly used, and usually requires general anesthesia.
How to prepare for the test
This test may require an overnight stay in the hospital. Fasting is required for 6 to 12 hours before the test. Your doctor may want you to avoid any aspirin or ibuprofen medications before the procedure. You must sign an informed consent form. Arrange for transportation to and from the hospital. Many people want to rest the following day, so make arrangements for work, child care, or other obligations.
How the test will feel
Local anesthesia is used to relax the throat muscles. Until the anesthetic begins to work, there will be a feeling of fluid running down the back of the throat and the need to cough or gag.
When the anesthetic wears off, the throat may be scratchy for several days. After the test, the cough reflex will return in 1 to 2 hours. Eating and drinking are not allowed until then.
Why the test is performedThis test is recommended if another diagnostic procedure suggests a lung disease that requires an inspection of the airways or a tissue sample for diagnosis. Bronchoscopy is also recommended if you have been coughing up blood (hemoptysis).
The trachea and bronchi have normal cells and secretions and no foreign bodies or obstructions.
What abnormal results mean
Additional conditions under which the test may be performed
Bronchoscopy can be used to evaluate almost any disease in pulmonary medicine, including:
What the risks are
The main risks from bronchoscopy are:
There is also a small risk of:
In the rare instances when general anesthesia is used, there is some risk for:
There is a small risk for:
When a biopsy is taken, there is a risk of hemorrhage. Some bleeding is common. However, the technician or nurse will monitor the amount of bleeding.
After the procedure, your gag reflex will return. However, until it does, do not eat or drink anything. To test if the gag reflex has returned, place a spoon on the back of your tongue for a few seconds with light pressure. If there is no gagging, wait 15 minutes and attempt it again. Make sure that no small or sharp objects are used to test this reflex.
Update Date: 1/27/2004Allen J. Blaivas, D.O., Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospital, Newark, NJ. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT