What is a Flexible Bronchoscopy?

Flexible bronchoscopy is a procedure that allows a clinician to examine the breathing passages (airways) of the lungs (figure 1). Flexible bronchoscopy can be either a diagnostic procedure (to find out more about a possible problem) or a therapeutic procedure (to try to treat an existing problem or condition).

Reasons for Bronchoscopy

Common reasons for bronchoscopy include the following:
Unexplained symptoms related to the chest, such as persistent cough, coughing up blood, wheezing, hoarseness, noisy breathing, or shortness of breath. The airways are examined for signs of problems and samples of tissue (biopsies) can be taken and examined for evidence of infection or cancer.

Persistent lung collapse (atelectasis) or collapse of the small air sacs in the lungs is sometimes evaluated using bronchoscopy. This may reveal a blockage, called an obstruction, from thick mucus, a foreign body, or a tumor. If possible, the clinician removes the cause of the obstruction to open the airways. Biopsies of abnormal tissue may be taken. In some cases, small tubes, called stents, are placed to hold the obstructed airway open.

An abnormal chest x-ray may suggest problems that require closer inspection with bronchoscopy. Examples include a “spot” or mass, pneumonia, or other unexplained changes on chest x-ray or computed tomography (CT) scans. In most cases, fluid samples or a biopsy are obtained to look for signs of infection, cancer, or inflammation.

Preparations For Flexible Bronchoscopy

Blood tests may be needed before the procedure to ensure that you have no problems related to blood clotting. Bleeding can sometimes occur after bronchoscopy, especially if tissue samples are taken.

You may be asked to discontinue blood thinning medications (including aspirin, clopidogrel, and warfarin) several days prior to the procedure. It’s important to understand instructions about how and when to take other medications before the procedure, and also whether smoking is permitted. In addition, it is important to mention if you have had previous allergic reactions or complications during medical or dental procedures.

It is important not to eat or drink for at least eight hours before the procedure. Dentures or other removable devices should be removed from the mouth.