(Flexible Bronchoscopy, Fiberoptic Bronchoscopy, FOB, Rigid Bronchoscopy)
Bronchoscopy is a procedure that allows the doctor to directly visualize the interior passageways of the lower respiratory tract through a bronchoscope (a long, narrow, fiberoptic, lighted tube inserted through the nose or mouth). With the bronchoscope, the doctor can see the larynx (voice box), trachea (windpipe), bronchi (large airways to the lungs), and bronchioles (smaller branches of the bronchi).
There are two types of bronchoscopies, characterized by the type of bronchoscope used: flexible or rigid. The type of bronchoscope used will determine the extent to which the bronchioles of the lung are visualized.
With a flexible bronchoscope, the doctor is able to visualize not only the tissue of the larger airways (trachea and bronchi), but also that of the smaller sections (bronchioles) as well. The design of the flexible bronchoscope is advantageous because it can be maneuvered into the smaller bronchioles, yielding more information about their condition than can be determined with a rigid bronchoscope.
In addition, the flexible, fiberoptic bronchoscope has interior channels which increase the capabilities of treatment options, such as delivering oxygen, suctioning secretions, obtaining tissue samples (biopsy), instilling medications, and laser therapy.
A rigid bronchoscope is a straight, metal, lighted tube capable of visualizing only the larger airways, thus limiting the diagnostic and therapeutic options available. However, certain conditions may warrant its use, such as aspiration, or removal, of a large amount of secretions and/or blood, controlling significant bleeding, or removal of foreign objects and/or lesions (diseased tissue) within the bronchi. Generally, the rigid bronchoscope has been replaced by the flexible bronchoscope because it has less risk of traumatizing the tissue, improved patient tolerance, and provides better access to smaller areas of the lung tissue.
Other related procedures that may be used to diagnose lung problems include chest X-ray, computed tomography (CT scan) of the chest, bronchography, chest fluoroscopy, chest ultrasound, lung scan, lung biopsy, mediastinoscopy, positron emission tomography (PET scan) of the chest, and pulmonary angiogram. Please see these procedures for additional information.
The respiratory system is made up of the organs involved in the exchange of gases--primarily oxygen and carbon dioxide--and consists of the:
The upper respiratory tract includes the:
The lower respiratory tract includes the lungs, bronchi, and alveoli.
The lungs take in oxygen, which cells need to live and carry out their normal functions. The lungs also get rid of carbon dioxide, a waste product of the body's cells
The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm).
The lungs are enveloped in a membrane called the pleura.
The lungs are separated from each other by the mediastinum, an area that contains the following:
The right lung has three sections called lobes. The left lung has two lobes. When you breathe, the air enters the body through the nose or the mouth. It then travels down the throat through the larynx (voice box) and trachea (windpipe) and goes into the lungs through tubes called mainstem bronchi.
One mainstem bronchus leads to the right lung and the other leads to the left lung. In the lungs, the mainstem bronchi divide into smaller bronchi and then into even smaller tubes called bronchioles. Bronchioles end in tiny air sacs called alveoli.
A bronchoscopy may be performed for diagnostic and/or therapeutic reasons. Diagnostic indications may include, but are not limited to, the following:
Therapeutic uses of bronchoscopy may include, but are not limited to, the following:
There may be other reasons for your doctor to recommend a bronchoscopy.
As with any invasive procedure, complications may occur. Complications related to bronchoscopy may include, but are not limited to, the following:
Contraindications for bronchoscopy may include severe tracheal stenosis (narrowing or obstruction of the trachea) and pulmonary hypertension (elevated blood pressure in the lungs’ blood vessels). Patients with hypercapnia (elevated carbon dioxide level in the blood) and/or severe shortness of breath may require intubation prior to the procedure, so that oxygen can be delivered directly into the lungs while the bronchoscope is in place.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Severe coughing and/or gagging may interfere with a bronchoscopy.
A bronchoscopy may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices. A rigid bronchoscopy is usually performed in the operating room under general anesthesia.
Generally, a fiberoptic bronchoscopy procedure follows this process:
After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed on an outpatient basis, you should plan to have another person drive you home.
You will not be allowed to eat or drink anything until your gag reflex has returned. You may notice some soreness of your throat and pain with swallowing for a few days. This soreness is normal.
You may be instructed to gently cough up and spit your saliva into a basin. The nurse will monitor your secretions. Your secretions may be blood tinged.
You may have a chest X-ray performed after the procedure.
You may resume your usual diet and activities after the procedure, unless your doctor decides otherwise. You may be advised to wait 24 hours before returning to your normal activities.
Your voice may sound hoarse after the procedure. Your doctor may recommend a throat lozenge or spray.
Notify your health care provider to report any of the following:
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.
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