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What Is Bronchoscopy?

Bronchoscopy (bron-KOS-ko-pee) is a procedure that allows your doctor to look inside your lungs' airways, called the bronchi (BRONG-ki) and bronchioles (BRONG-ke-ols). The airways carry air from the trachea (TRA-ke-ah), or windpipe, to the lungs.

During the procedure, your doctor inserts a thin, flexible tube called a bronchoscope into your nose or mouth. The tube is passed down your throat into your airways. If you have a breathing tube, the bronchoscope can be passed through the tube to your airways. You’ll be given medicine to make you relaxed and sleepy during the procedure.

The bronchoscope has a light and small camera that allow your doctor to see your windpipe and airways and take pictures.

If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.

A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia (AN-es-THE-ze-ah). The term "anesthesia" refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.

Overview

Bronchoscopy can help find the cause of a lung problem. For example, during the procedure, your doctor may see:

  • A tumor
  • Signs of infection
  • Excess mucus in the airways
  • The site of bleeding
  • A blockage (such as a piece of food) in your airway

Your doctor also may take samples of mucus or tissue from your lungs to test in a laboratory.

Sometimes doctors use bronchoscopy to treat lung problems. For example, the procedure might be done to insert a stent in an airway. An airway stent is a small tube that holds the airway open. It might be used if a tumor or other condition blocks the airway.

In children, bronchoscopy most often is used to remove an object blocking an airway. Sometimes it's used to find out what's causing a cough that has lasted for at least a few weeks.

Researchers are studying new types of flexible bronchoscopy. They might make it easier to detect tumors and other lung problems, especially in the lungs’ small airways. These procedures also might make it easier to take fluid and tissue samples from your lungs.

Newer types of bronchoscopy include:

  • Endobronchial (EN-do-BRONG-ke-al) ultrasound. This procedure uses sound waves to create pictures of the insides your airways.
  • Fluorescence (flor-ES-ents) bronchoscopy. This procedure uses fluorescent light instead of white light to look inside your airways.
  • Virtual bronchoscopy. This procedure uses a new method of computed tomography (to-MOG-rah-fee) scan, or CT scan. Virtual bronchoscopy can create detailed pictures of your airways.

Outlook

Bronchoscopy is a safe procedure. Side effects and complications usually are minor. You may feel hoarse and have a sore throat after the procedure. Minor bleeding, infection, and fever also can occur.

A rare, but more serious risk is a pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse.




Who Needs Bronchoscopy?

Your doctor may recommend bronchoscopy if you have an abnormal chest x ray or chest CT scan. These tests may show a tumor, a pneumothorax (collapsed lung), or signs of an infection.

A chest x ray creates a picture of the structures in your chest, such as your heart and lungs. A chest CT scan uses special x rays to create detailed pictures of the structures in your chest.

Other reasons for needing bronchoscopy include coughing up blood or having a cough that lasts more than a few weeks.

Sometimes doctors use bronchoscopy to treat lung problems. For example, the procedure might be used to:

  • Remove something that's stuck in an airway (like a piece of food).
  • Place medicine in a lung to treat a lung problem.
  • Insert a stent (small tube) in an airway to hold it open. A stent might be used if a tumor or other condition blocks an airway.

Doctors also can use bronchoscopy to check for swelling in the upper airways and vocal cords of people who were burned around the throat area or who inhaled smoke from a fire.

In children, the procedure most often is used to remove an object blocking an airway. 




What To Expect Before Bronchoscopy

Bronchoscopy is done in a hospital or special clinic. To prepare for the procedure, tell your doctor:

  • What medicines you're taking, including prescription and over-the-counter medicines. It's helpful to give your doctor a list of your medicines.
  • Whether you’ve had any bleeding problems.
  • Whether you have any allergies to medicines or latex.

You’ll be given medicine before the procedure to help you relax. The medicine will make you sleepy, so you should arrange for a ride home after the procedure.

You’ll have to fast (not eat or drink anything) for 6–12 hours before the procedure. Your doctor will let you know the exact amount of time you should fast.




What To Expect During Bronchoscopy

Your doctor will do the bronchoscopy in an exam room at a hospital or special clinic. The procedure usually lasts about 30 minutes. But the entire process, including preparation and recovery time, takes about 4 hours.

Your doctor will give you medicine through an intravenous (IV) line in your bloodstream or by mouth. The medicine will make you relaxed and sleepy.  

Your doctor also will squirt or spray a liquid medicine into your nose and throat to numb them. This helps prevent coughing and gagging when the bronchoscope (long, thin tube) is inserted.

Next, your doctor will insert the bronchoscope through your nose or mouth, down your throat, and into your airways. As the tube enters your mouth, you may gag a little. Once it enters your throat, that feeling will go away.

Your doctor will look at your vocal cords and airways through the bronchoscope (which has a light and a small camera).

The animation below shows a bronchoscopy procedure. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.

The animation shows how a doctor inserts a bronchoscope into a patient’s nose and passes it down into the airways. This allows the doctor to look inside the airways.

During the procedure, your doctor may take a sample of lung fluid or tissue for further testing. Samples can be taken using:

  • Bronchoalveolar lavage (BRON-ko-al-VE-o-lar la-VAHZH). For this method, your doctor passes a small amount of saline solution (salt water) through the bronchoscope and into part of your lung. He or she then suctions the salt water back out. The fluid picks up cells and bacteria from the airway, which your doctor can study.
  • Transbronchial lung biopsy. For this method, your doctor inserts forceps into the bronchoscope and takes a small tissue sample from inside the lung.
  • Transbronchial needle aspiration. For this method, your doctor inserts a needle into the bronchoscope and removes cells from the lymph nodes in your lungs. These nodes are small, bean-shaped masses. They trap bacteria and cancer cells and help fight infections.

You may feel short of breath during bronchoscopy, but enough air is getting to your lungs. Your doctor will check your oxygen level. If the level drops, you'll be given oxygen.

If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.

A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia. The term "anesthesia" refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.

After the procedure is done, your doctor will remove the bronchoscope.

Newer Types of Bronchoscopy

Researchers are studying new types of flexible bronchoscopy. They might make it easier to detect tumors and other lung problems, especially in the lungs’ small airways. These procedures also might make it easier to take fluid and tissue samples from your lungs.

Endobronchial Ultrasound

This procedure is done the same way as a standard flexible bronchoscopy. However, an ultrasound probe is attached to the end of the flexible tube. The probe uses sound waves to create pictures of your lungs. Your doctor can see these pictures on a computer screen.

Fluorescence Bronchoscopy

This procedure also is done the same way as a standard flexible bronchoscopy. However, a fluorescent light is attached to the bronchoscope instead of a white light. Under fluorescent light, tiny tumors look dark red, and healthy tissue looks green.

During the test, your doctor can remove cells from the lymph nodes in your lungs for testing.

Virtual Bronchoscopy

This procedure uses a new method of computed tomography (CT) scan to look inside your lungs. Virtual bronchoscopy uses special x rays to create detailed pictures of your lungs’ airways. A bronchoscope is not used for this procedure.

During the scan, you lie on a table that slides through the center of a tunnel-shaped x-ray machine. X-ray tubes in the scanner rotate around you and take pictures of your lungs and airways.




What To Expect After Bronchoscopy

After bronchoscopy, you'll need to stay at the hospital or clinic for up to a few hours. If your doctor uses a bronchoscope with a rigid tube, the recovery time is longer. While you're at the clinic or hospital:

  • You may have a chest x ray if your doctor took a sample of lung tissue. This test will check for a pneumothorax and bleeding. A pneumothorax is a condition in which air collects in the space around the lungs. This can cause one or both lungs to collapse.
  • A nurse will check your breathing and blood pressure.
  • You can't eat or drink until the numbness in your throat wears off, which will take about 1–2 hours.

After recovery, you'll need someone to drive you home because you'll be too sleepy to drive.

If samples of tissue or fluid were taken during the procedure, they'll be tested in a laboratory (lab). Talk to your doctor about when you'll get the lab results.

Recovery and Recuperation

Your doctor will let you know when you can return to your normal activities, such as driving, working, and physical activity.

For the first few days, you may have a sore throat, cough, and hoarseness. Call your doctor right away if you:

  • Develop a fever
  • Have chest pain
  • Have trouble breathing
  • Cough up more than a few tablespoons of blood



What Does Bronchoscopy Show?

During bronchoscopy, your doctor may see a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or a blockage in your airway.

Endobronchial ultrasound can show enlarged lymph nodes and tumors in and near the airways. Enlarged lymph nodes can suggest an infection or other problem. The procedure also is used to determine the extent of lung cancer.

Fluorescence bronchoscopy can show an abnormal lesion that can’t be seen with standard flexible bronchoscopy. Some lesions may become cancerous. When lesions are detected early, they may be easier to treat.

Virtual bronchoscopy can show lung problems in the tiny branches of the airways and outside of the airways.

Your doctor will use the results of your bronchoscopy to decide how to treat any lung problems that were found. He or she may recommend other tests or procedures.




What Are the Risks of Bronchoscopy?

Bronchoscopy is a safe procedure, and complications usually are minor. They might include:

  • A drop in your oxygen level during the procedure. Your doctor will give you oxygen if this happens.
  • Minor bleeding, infection, and fever.

A rare, but more serious risk is a pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse.

A small pneumothorax might go away on its own. However, if it interferes with breathing, your doctor may use a chest tube to remove the air.

After bronchoscopy, your doctor may suggest that you have a chest x ray to check for complications.




Clinical Trials

The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.

NHLBI-supported research has led to many advances in medical knowledge and care. For example, this research has helped look for better ways to diagnose and evaluate lung problems using procedures such as bronchoscopy.

The NHLBI continues to support research on bronchoscopy. For example, the NHLBI currently sponsors a study to explore how bronchoscopy can help improve the understanding of inflamed airways and asthma.

Much of the NHLBI's research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions.

For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.

By taking part in a clinical trial, you may gain access to new treatments before they're widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don't directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.

If you volunteer for a clinical trial, the research will be explained to you in detail. You'll learn about treatments and tests you may receive, and the benefits and risks they may pose. You'll also be given a chance to ask questions about the research. This process is called informed consent.

If you agree to take part in the trial, you'll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.

For more information about clinical trials related to bronchoscopy, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:

For more information about clinical trials for children, visit the NHLBI's Children and Clinical Studies Web page.




Links to Other Information About Bronchoscopy

Non-NHLBI Resources

Clinical Trials

 
February 08, 2012 Last Updated Icon

The NHLBI updates Health Topics articles on a biennial cycle based on a thorough review of research findings and new literature. The articles also are updated as needed if important new research is published. The date on each Health Topics article reflects when the content was originally posted or last revised.

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