Bronchoscopy: what is it and how is it performed?

By Cristiano Antonino On Feb 17, 2023

Bronchoscopy is the analysis of the bronchi by visualising the bronchial tree: it allows direct observation of the larynx, trachea and bronchi, through which air reaches the lungs

Bronchoscopy makes it possible to detect obstructive or inflammatory phenomena in the bronchi

Traditionally, it is used to diagnose lung tumours, inflammatory diseases, pulmonary fibrosis, sarcoidosis and obstructive bronchial diseases (such as bronchial asthma and COPD).

Bronchoscopy is performed in cases where X-ray images need to be specified, in patients with blood in their sputum (haemoptysis) or persistent cough and following the inhalation of foreign bodies.

It also makes it possible to take secretions and fragments of bronchial mucosa for analysis.

How it is performed

The test is performed using an instrument known as a bronchoscope (or fibrobronchoscope), a thin fibre-optic tube that is introduced through the mouth or nose.

In order to detect any problems – such as heart disease in an unstable phase – that may lead to complications, the bronchoscopy must be preceded by an electrocardiogram and some blood tests.

The patient must also have been fasting for at least 12 hours.

Bronchoscopy is performed under local anaesthesia by inhaling a pulverised anaesthetic

The bronchoscope does not cause complete obstruction of the airways and therefore does not compromise breathing, although the introduction of the instrument may cause coughing or gagging.

In any case, breathing will be monitored by means of a pulse oximeter to assess the need to administer supplementary oxygen.

A bronchoscopy lasts about 30 minutes and the results can be reported as soon as the test is completed.

At the end of the test, after an observation period that varies depending on the progress of the test, one can return home, but it is advisable not to drive, to remain fasting for another 2 hours and to rest for 24 hours.

A slight burning sensation in the throat may appear after a few hours, which usually passes in one or two days.

Complications are rare, but if difficulty breathing, high fever, dysphonia and episodes of blood in the sputum occur, a doctor should be consulted.

Rigid bronchoscopy, on the other hand, is performed under general anaesthesia and is mainly indicated in paediatric bronchoscopy or operative bronchoscopy.

The two methods (rigid bronchoscopy and fibro-bronchoscopy) can also be performed in combination.

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