Bronchoscopy is an examination of the trachea (windpipe) and bronchi using a special set of optical instruments – a bronchofiberscope or a rigid bronchoscope (a metal pipe with lenses). Due to its smaller diameter and elasticity, a bronchofiberscope allows as well for the assessment of the smaller tubes, bronchioli.
Both a bronchoscope and a bronchofiberscope make it possible to introduce additional instruments (including pliers, a catheter or a brush) to collect a tissue specimen or secretion from the bronchial tree.
This procedure is used to identify the causes of such symptoms as coughing, haemoptysis (coughing up of blood), and supplements radiological examinations of the chest.
Bronchoscopy makes it possible to:
- assess the vocal cords, trachea (windpipe), main bronchial tubes and their subdivisions within the lungs in order to identify pathological changes;
- collect samples for microscopic examination, including specimens of tissues from suspicious sites, secretions for the presence of bacteria, fungi or tubercle bacilli.Bronchoscopic examination is performed to diagnose respiratory diseases and determine the manner of treatment.
Bronchoscopic examination is performed to diagnose respiratory diseases and determine the manner of treatment. Bronchoscopy can also be used to:
- perform therapeutic procedures, e.g. local drug administration;
- remove a foreign body;
- aspirate airway secretion.
Bronchofiberscopy is predominantly performed under local anaesthesia. In certain cases, this procedure requires general anaesthesia. The anaesthesia is the choice of a physician, who adapts its type individually for each patient depending on his/her general health. A bronchofiberscopic examination requires the patient to lie down or remain seated. Before the examination, the physician administers local anaesthesia on the back wall of the patient’s throat, the root of the tongue and the vocal cords. The anaesthetic agent helps the patient to overcome his/her gag reflexes and makes the patient’s throat numb. Next, the physician introduces a fiberscope through the patient’s nostrils and injects a few millilitres of medication through the fissure between the vocal cords of the trachea (windpipe). In the event of cough reflexes after the fiberscope has been introduced into the trachea and bronchial tubes, it is possible to administer additional dose of the anaesthetic.
Using biopsy pliers or a brush, the physician collects specimens of the tissue and cell material for microscopic (cytological, histopathological) and/or bacteriological examination. The procedure usually takes from 15 to 30 minutes. If required, it can be repeated many times. It is performed in patients of all ages, upon medical referral.
Preparation for the examination:
- on the day of the examination, the patient must be fasting - no eating and drinking for at least 4 hours before the examination, to avoid the risk of choking and the related complications.
- if the patient takes any medications regularly, for example due to coronary heart disease, hypertension, etc., he/she should take them as usual, drinking a minimal amount of liquid to help swallowing.
- if the patient is on insulin treatment, he/she is requested to skip the morning dose of insulin.
- the patient should bring all of their previous radiological documentation (written desc.riptions, imgages on film and CDs) for the examination.
Prior to the examination, inform the person performing the procedure about the following:
- susceptibility to bleeding (purpura/haemorrhagic diathesis);
- allergy: bronchial asthma, hay fever and hypersensitivity to medications (e.g. local anaesthetics);
- heart rhythm disturbances (arrhythmias), heart defects, angina pectoris (coronary heart disease), hyper- or hypotension;
- dentures in your mouth.
After the examination:
Due to the anaesthesia applied, it is necessary to refrain from eating and drinking for at least 2 hours after the examination to avoid choking (the anaesthetic reduces the swallowing reflex). If minor haemoptysis (coughing up of blood) occurs, it is enough to lie still in bed for a few hours.
Potential complications after the examination:
- short-term hoarseness;
- haemoptysis (coughing up of blood) – a possible, yet a very infrequent complication may be a bleeding that requires a surgical intervention.
Exceptional and rare complications after the examination might include: injuries to the larynx, trachea (windpipe) and bronchi, fracture of a tooth, air entering the pleural cavity (pneumothorax), fever, cardiac arrhythmias, respiratory disorders, laryngospasm and bronchospasm as well as allergic reactions to local anaesthetics.