What is a Bronchoscopy?

A bronchoscopy is a test that allows doctors to examine your airways. An instrument called a bronchoscope is threaded through your nose or mouth and down your throat to reach your lungs. The bronchoscope has a light source and a viewing device. The bronchoscope can be a rigid or it can be made from a more flexible fiber-optic material.
Using the bronchoscope, the doctor can view your all of the structures that make up your respiratory system including the larynx, trachea, and the smaller airways of the lungs—the bronchi.

Bronchoscopy can be used to diagnose lung disease, tumors, chronic cough, or an infection. A bronchoscopy may be needed if you have an abnormal chest X-ray or CT scan that shows evidence of an infection, a tumor, or a collapsed lung.

The test is also sometimes used as a treatment tool. For example, a bronchoscopy can deliver medication to the lungs or remove a piece of food that is caught in your airways

Preparing for a Bronchoscopy

Most people will require a local anaesthetic to be applied to their nose and throat during the bronchoscopy test. A sedative is typically given to help you relax. This means that you will be awake but drowsy during the exam. An anaesthetist is usually present to administer sedation and monitor your heart and oxygenation.

You will need to fast for six to 12 hours before the bronchscopy. You may need to stop taking aspirin, ibuprofen, warfarin, or other blood thinners before your bronchoscopy. Bring someone with you to your appointment or arrange for transportation to drive you home afterward.

Bronchoscopy Procedure

Once you are relaxed, the bronchoscope (a thin, flexible tube) will be inserted into your nose or mouth. The bronchoscope passes from your nose/ mouth down to your throat until it reaches your bronchi. The bronchi are the airways in your lungs.

Your doctor may wash your lungs by sending a warm saline solution through the bronchoscope and then sucking it back out. Cleaning your airways makes examination easier and gives the doctor samples of your lung cells and secretions. Brushes or needles may be attached to the bronchoscope to collect tissue samples from your lungs. These samples can help your doctor diagnose any lung conditions you may have.

Depending on your specific condition, the doctor may observe:

If a tumor is seen a sample (biopsy) will be taken for diagnosis. A foreign body can be removed with the bronchoscope. When your doctor is finished examining your lungs, the bronchoscope is removed.

Advanced Technology for Bronchoscopies

Advanced forms of imaging technology are sometimes used to conduct a bronchoscopy. These advanced techniques can provide a more detailed picture of the inside of your lungs.

Virtual bronchoscopy: uses CT scans to see your airways in more detail.
Endobronchial ultrasound: uses an ultrasound probe attached to the bronchoscope to see your airways.
Fluouresence bronchoscopy: uses a fluorescent light attached to the bronchoscope to see the insides of your lungs.

Risks of a Bronchoscopy

Bronchoscopy is safe for most people. However, like all medical procedures, there are some risks involved. Risks may include bleeding (especially if you have had a biopsy), infection, and trouble breathing or a low blood oxygen level during the test.

Very rare but potentially life-threatening risks of bronchoscopy include heart attack and lung collapse. A collapsed lung can be due to a pneumothorax or the escape of air into the lining of the lung causing pressure on the lung. This results from a puncture of the lung during the procedure and is more common with a rigid bronchoscope than with a flexible fiberoptic scope. If air collects around your lungs during the procedure (which could cause lung collapse), your doctor can use a chest tube to remove it.

Recovery From a Bronchoscopy

The bronchoscopy test is relatively quick, lasting about 30 minutes. Because you will be sedated, you will rest at the hospital for a couple of hours until you feel more awake and the numbness in your throat wears off. Your breathing and blood pressure will be monitored during your recovery.

You won’t be able to eat or drink anything until your throat is no longer numb. This can take one to two hours. Your throat might feel sore or scratchy for a couple of days, and you might be hoarse. This is normal, usually of short duration, and resolves without treatment.. Contact your doctor, however, if you:

run a fever
cough up blood
have trouble breathing
These symptoms can indicate an infection and require medical attention.