Bronchoscopy
Revising Medical Author: George Schiffman, MD
Revising Medical Editor: Melissa Conrad Stöppler, MD
What is bronchoscopy?
Bronchoscopy is a procedure during which an examiner
uses a viewing tube to evaluate a patient's lung and
airways including the voice box and vocal cord, trachea,
and many branches of bronchi. Bronchoscopy is usually
performed by a pulmonologist or a thoracic surgeon.
Although a bronchoscope does not allow for direct viewing
and inspection of the lung tissue itself, samples of the
lung tissue can be biopsied through the bronchoscope for
examination in the laboratory.
There are two types of bronchoscopes - a flexible fiberoptic bronchoscope and a rigid bronchoscope. Since the
1960s, the fiberoptic bronchoscope has progressively
supplanted the rigid bronchoscope because of overall ease
of use. In some patients, flexible fiberoptic bronchoscopy can be performed
without anesthesia, but in most cases, conscious sedation "twilight sleep") is
utilized. However, rigid bronchoscopy requires general anesthesia and the
services of an anesthesiologist. During the bronchoscopy, the examiner can see
the tissues of the airways either directly by looking
through the instrument or by viewing on a TV monitor.
Depending on the indication the examiner will choose between the flexible
fiber optic bronchoscope or the rigid bronchoscope. For example, if a patient were coughing up large amounts of blood, a rigid bronchoscope is used since it has a large suction channel and allows for the use of instruments that can better control bleeding. The vast majority of bronchoscopies are performed using the flexible fiberoptic scope because of the improved patient comfort and reduced use of anesthesia.
What are the indications for bronchoscopy?
Bronchoscopy can be used for diagnosis or treatment.
(The lists below are not meant to be all-inclusive, but are
intended to provide a greater awareness and knowledge
regarding the indications for bronchoscopy.)
Bronchoscopy is used to make a diagnosis most
commonly for these conditions:
- persistent or unexplained cough;
- blood in the sputum (coughed up mucus material from
the lungs);
- abnormal chest x-ray such as a mass, nodule, or
inflammation in the lung; or
- evaluation of a possible lung infection.
Bronchoscopy is used for treatment:
- to remove foreign bodies in the airway;
- to place a stent (a tiny tube) to open a collapsed
airway due to pressure by a mass or tumor; or
- to remove a mass or growth that is blocking the
airway.
Next: What are the potential complications of bronchoscopy? »
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