A bronchoscopy is a medical imaging procedure in which an instrument known as a bronchoscope is inserted into the airway to allow a doctor to see the trachea, bronchi, voice box, mucosal lining, and other structures of the airway. This procedure is usually performed by a pulmonologist, a doctor who specializes in conditions which involve the respiratory tract. He or she may be assisted by nurses, anesthesiologists, and other support staff.
Rigid bronchoscopy is performed under general anesthesia with a rigid tube, while flexible bronchoscopy uses a flexible tube and local anesthetic. The flexible method is generally preferred because it is safer and more comfortable for the patient, but there may be situations in which a rigid bronchoscope would be more appropriate.
Some common reasons to perform a bronchoscopy include: placing an endotracheal tube, clearing an airway obstruction, taking a biopsy sample, screening for cancer, or investigating inconclusive results from other types of imaging studies such as x-rays and CT scans. Doctors can also use special tools with the bronchoscope such as fluorescent lights which can reveal signs of cancerous growths, or grippers which can be used to grasp and remove an airway obstruction.
Prior to a bronchoscopy procedure, a patient is usually advised to avoid eating and drinking for eight to 12 hours. He or she must also disclose any medications being used, and certain medications may need to be avoided for several hours in advance of the procedure. For the bronchoscopy, the patient is usually given medications to reduce oral secretions and relax, along with a local anesthetic which makes the airway numb during the procedure.
Patients can sit or lie down for a bronchoscopy. They are often asked to undress and wear a hospital gown so that the medical team will have easy access if the patient experiences complications. The procedure can be uncomfortable, and many patients want to gag or cough while the scope is inserted and removed. After the procedure, soreness in the airway and a hoarse voice are very common.
The medications used with a bronchoscopy can sometimes cause complications or adverse reactions, especially in the case of the general anesthetic used in rigid bronchoscopy procedures. Otherwise, the procedure is usually very safe, and it can be a highly effective diagnostic and screening tool. When this medical procedure is recommended, a patient may want to discuss the reasons for the bronchoscopy and concerns about risks with a pulmonologist to learn more about the process and the possible results.