What is a Bronchoscopy?

Ocala Lung & Critical Care is often asked “Why do I need a Bronchoscopy?”
Here are a few of the common reasons and conditions we look for or examine further during a Bronchoscopy.

• Infections and Diseases of the Lungs – When a patient is suspected of having a serious infection, bronchoscopy is performed to get better samples from a particular area of the lung. These samples can be looked at in a lab to try to find out the exact cause of the infection.
• Lung Spots – An X-ray film or CT scan may reveal an abnormal finding (“ lung spot”) in the lung. This can be caused by an infection, cancer, or even inflammation. A Bronchoscopy allows Ocala Lung & Critical Care to take samples from the area. These samples are then viewed and tested in a lab to identify the specific cause of any lung spots.
• Persistent Collapsing of the Lung – The collapse of a lung or part of a lung (atelectasis) is often caused by something, such as a tumor or a thick mucus that blocks the airway passages. Through a Bronchoscopy Ocala Lung & Critical Care can see the blockage, obtain a sample and/or remove the substance; resulting in an airway that is more open.
• Bleeding of the Lungs – When a patient has coughed up blood there are different reasons that could have caused the bleeding. A Bronchoscopy can help your doctor find the cause of the bleeding. For example, if a tumor is causing the bleeding (although a tumor is not the only potential cause, therefore one should not assume they have a tumor when bleeding of the lungs is present), the doctor will locate the tumor and take samples of tissue (biopsies) through the Bronchoscope. The samples are further reviewed and tested in a lab to help clearly identify the type of tumor.
• Restricted or Narrowing Airways and associated Noisy Breathing – A person can have noisy or abnormal breathing sounds that may be caused by a problem with the throat or airways of the lung. This could include shortness of breath, noisy breathing, or labored breathing during sleep. The bronchoscopy allows the doctor to look directly at your throat, vocal cord area, and major airways to identify any problems. Causes of this type of breathing may include vocal cord paralysis or weakness, a blood vessel pressing on the outside of the airway (Vascular Compression) , or floppiness in the airways (Bronchomalacia) or voice box (Laryngomalacia).

How is a Bronchoscopy performed?

The bronchoscopy procedure can be performed via several different methods, including the one above. Regardless of the approach taken, unless in rare or complex situations, all Bronchoscopies are performed on an Outpatient basis, meaning there is typically no overnight hospital stay.

The most common Bronchoscopy procedures are explained in more detail below.

Flexible Bronchoscopy

Fiberoptic Bronchoscopy involves placing a thin tube-like instrument (the Bronchoscope) through your nose or mouth which proceeds down into the airways of your lungs. The mini-camera at the Bronchoscope’s tip transmits pictures back to a video screen or camera for your doctor to view and assess.

Rigid Bronchoscopy

A Rigid Bronchoscopy is an invasive procedure. This may be performed in an endoscopy suite with available anesthesia, but also may occur in the operating room. A Rigid Bronchoscopy is commonly combined with the above Flexible Bronchoscopy to obtain and maintain more precise distal airway visualization and suctioning.

Navigational Bronchoscopy

Bronchi within your lungs consist of varying shapes and sizes. At the outer reaches of your lungs the Bronchi are smaller. As such they are not wide enough to permit a normal bronchoscope to pass. By using Navigational Bronchoscopy Ocala Lung & Critical Care can find and reach tumors located in the periphery of your lungs. This is one of the greatest advancements to Bronchoscopy procedures. As with the other types of Bronchoscopies we can can find lung tumors, take biopsies and even administer treatment with Navigational Bronchoscopy.

Bronchoscopy Complications

Bronchoscopies are a common procedure. Even with common procedures such as receiving a flu shot, there can still be complications.

Here are some of the Bronchoscopy Complications patients sometimes encounter.

• Discomfort and Coughing—While the Bronchoscope is passed through your nose or throat into the lungs, it may cause some discomfort. It may also tickle your airways, causing a cough. A local anesthetic is administered that is sprayed into your nose or throat, as well as medicine (sedatives) by vein to lessen any coughing, gagging, or unpleasant sensations felt during the procedure.
•  Reduced oxygen—The level of oxygen in the blood could fall during the procedure for several reasons.
• The Bronchoscope could block the flow of air into the airway, or small amounts of liquid used during the test may be left behind, causing your oxygen level to drop. This drop is usually mild, and the level usually returns to normal without treatment.
• If the oxygen level remains low, your doctor will provide extra oxygen. In rare instances we may even stop the test to allow for recovery. Throughout a Bronchoscopy your oxygen level is continuously monitored via an oxygen sensor clip (pulse oximeter) that is placed on your finger.
•  Lung Leak or Collapse— Depending on the current health of your lungs, the airway could be injured further by the Bronchoscope, particularly if the lung is already very inflamed or diseased. If the lung is punctured, it may cause an air leak (pneumothorax), which can cause the lung to then collapse. This complication is not common, and is more likely if a biopsy is taken during bronchoscopy. A large or ongoing air leak may need to be drained with a chest tube.
• Bleeding—Bleeding can occur after your doctor performs a biopsy or if the Bronchoscope injures a tumor in the airways. As with a Lung Leak, bleeding is more likely if the airway is already inflamed or damaged by a lung disease. Usually bleeding is minor and does not require further treatment. Sometimes medication can be administered through the Bronchoscope to stop bleeding.

 Are there alternatives to a Bronchoscopy?

Yes there are! X-Rays, CT Scans, and suctioning techniques may also be used by doctors. However these approaches provide less information than a Bronchoscopy.

A Bronchoscopy is a precise approach for your doctor to use, as very specific samples can be obtained from the area(s) in question.

It is also common that some relief can be achieved through Bronchoscopy procedure.