Diagnosis of many lung diseases may be made by examination of the patient as well as with the aid of simple blood tests and chest x-rays. However, at times, further information is required and the doctor will recommend a procedure known as a bronchoscopy. A bronchoscopy allows inspection of the inside of the lungs and allows the physician to see any abnormalities that may exist (e.g. ulceration, blockage, bleeding). Additional information may also be obtained during this procedure if lung tissue is sampled through biopsies or washings. These samples are later analyzed in the laboratory. In addition to its diagnostic value, a bronchoscopy may be used for treatment purposes. For example, if a foreign object is inhaled, it could be removed by performing a bronchoscopy. Similarly, a patient may be producing too much sputum and not have the ability to cough it up. In such a situation, the sputum could be removed through a bronchoscope. 

The bronchoscope is a flexible plastic tube less than 1/2 inch wide and about 2 feet long. The scope is passed through the nose and into the back of the mouth. From there, it is advanced into the main windpipe (trachea). Branching off the trachea are two smaller windpipes (bronchi), which themselves branch many times. The bronchoscope can be further advanced into these areas. Throughout the procedure, the doctor will be looking into the other end of the instrument, which allows the doctor to direct the bronchoscope, see any abnormalities, and if necessary remove small samples from within the windpipes. 

Why it’s done 

Bronchoscopy is usually done to find the cause of a lung problem. For example, your doctor might refer you for bronchoscopy because you have a persistent cough or an abnormal chest X-ray. 

Reasons for doing bronchoscopy include: 

• Diagnosis of a lung problem 
• Identification of a lung infection 
• Biopsy of tissue from the lung 
• Removal of mucus, a foreign body, or other obstruction in the airways or lungs, such as a tumor 
• Placement of a small tube to hold open an airway (stent) 
• Treatment of a lung problem (interventional bronchoscopy), such as bleeding, an abnormal narrowing of the airway (stricture) or a collapsed lung (pneumothorax)