Bronchoscopy

How the Test is Performed:
The pulmonologist (a pulmonary (lung) specialist trained to perform a bronchoscopy) will spray a topical or local anesthetic in your mouth and throat. Then a cannula (a metal or stiff plastic tube about 6-inches long and curved on one end) is inserted, curved end first, to hold your tongue out of the way. An anesthetic is injected through the cannula, enabling it to run down the back of your throat, through the larynx, trachea, bronchial tubes, and into your lungs. This will cause coughing at first, which will cease as the anesthetic is increased. When the area feels "thick," it is sufficiently numb.

An anesthetic jelly will be inserted into one nostril. When it is numb, the scope will be inserted until it passes through the throat into the bronchus. Usually, a flexible bronchoscope is used. The flexible tube is less than 1/2-inch wide and about 2-feet long. The outside end is connected to several bottles on a nearby table and has an eyepiece. Some of the bottles are connected to a small motor that suctions out and collects the fluids of the bronchi. Other fluids can be introduced to flush the area and collect cells that may be analyzed by a pathologist. A rigid bronchoscope is rarely used.

How to Prepare:
This test may require an overnight stay in the hospital. A list of essentials is usually available from a doctor or clinic. Fasting is required for 6 to 12 hours before the test. 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.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:



How it Feels:
A local anesthesia is used to relax the throat muscles, so there is the feeling of fluid running down the back of the throat and the need to cough or gag until the anesthetic begins working.

Once the anesthetic takes effect, there may be sensations of pressure or mild tugging as the tube moves through the trachea. Many patients experience the feeling of suffocation when the tube is in the throat (there is no risk of suffocation). If there is coughing during the test, more anesthetic will be added.

An X-ray is often taken after the bronchoscope is removed to compare with the original (that indicated the need for the bronchoscopy). 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, then normal eating and drinking is allowed.

Risks:
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, and the technician or nurse will monitor the amount of bleeding.

There is a significant risk of choking if anything (including water) is ingested before the anesthetic wears off.

Why this Test is Performed:
This test is recommended if an X-ray or other diagnostic procedure suggests a tumor , obstruction in the tracheobronchial tree, or if the lung shows a disease that requires a tissue sample for diagnosis.

The flexible bronchoscope is beneficial in viewing the bronchi.

Normal Values:
The trachea and bronchi have normal secretions and no foreign bodies or obstructions.

Abnormal Results:

Additional conditions under which the test may be performed:



Cost:
The estimated cost is $1000.

Special Considerations:
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.


Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.