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What is Bronchoscopy?

Bronchoscopy is a procedure in which a thin tube with a camera, called a bronchoscope, is inserted in your mouth or nose and slowly advanced to your lungs. This allows your doctor to see your respiratory tract, which includes your throat, larynx (voice box), trachea (windpipe), bronchi (airways), and lungs. If you have or show signs of lung problems - for example, lung cancer or difficulty breathing - your doctor may recommend that you undergo a bronchoscopy.

In performing a diagnostic bronchoscopy, your doctor may only wish to visualize your respiratory tract, or your doctor may also collect samples of tissue or fluid. The samples can help diagnose your condition or, if you have cancer, they can be used for staging purposes. One method for sample collection is bronchoalveolar lavage. In a bronchoalveolar lavage, your doctor injects saline (salt water) through the bronchoscope and then suctions it out of your airways. The washout collected is tested for lung disorders. Your doctor can also insert a biopsy tool to collect tissue or mucus samples. The following are biopsies that can be performed by bronchoscopy:

  • Brush biopsy, which uses a brush to collect samples.
  • Endobronchial biopsy, which uses the bronchoscope to guide forceps to sample lung tissue.
  • Transbronchial biopsy, which uses forceps and image guidance - such as X-rays, CT scans, or fluoroscopy - to sample lung tissue.
  • Transbronchial fine needle aspiration (TBNA), which uses a small needle to take samples of the lymph nodes or lungs.

For visualization, bronchoscopy can be done alone, or it can be combined with ultrasound. Endobronchial ultrasound (EBUS) allows real-time imaging of your airway and is used for diagnosing and staging lung cancer, as well as for determining where the cancer has spread. EBUS can be performed with TBNA, a procedure known as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).

Your doctor can also use bronchoscopy as a treatment for lung problems. For example, if a foreign body is trapped in your airway, your doctor can insert forceps through the bronchoscope to remove it. If your airway has become narrowed - which may occur if you have an infection, cancer, or some other inflammatory issue - bronchoscopy can be used to place a device called a stent in the area of constriction. The stent will keep your airway open, allowing you to breathe properly.

During a bronchoscopy, you will be given medication (sedative) to help you relax. If it is only a diagnostic bronchoscopy, you will be kept awake, but if your bronchoscopy is for therapeutic purposes, you will be put to sleep by general anesthesia. After your procedure, you will need to stay in the hospital for a few hours. You will not be able to eat or drink for about 2 hours. You may experience some discomfort, such as a sore throat or pain while swallowing. Throat lozenges and gargling may help alleviate your symptoms, which should go away after a few days. You will need to have someone drive you home once your doctor determines that you are ready.

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