Bronchoscopy is the process of internal imaging the airways, i.e. the main trachea and bronchial tree. During this process, the anatomy of the throat, larynx, trachea and bronchial tree is examined.
There are many medical reasons for bronchoscopy. Two major reasons are:
- For diagnostic purpose: it is performed in case of the frequent presence of abnormal findings of a chest graph or computed tomography for various reasons, for differential diagnosis of pulmonary infections, for diagnostic and staging purpose of tumors in malignant or benign nature, for chronic cough with no response to treatment, bleeding accompanied by cough, and for hoarseness persisting more than two weeks.
- For treatment purpose: it is performed for removing foreign bodies in the airways, to provide contribution to the treatment of tumors in malignant and benign nature, which cause to excessive shortness of breath (using laser, argon plasma cauterization, cryocauterization, electrocauterization, etc.), and to implant stents due to stenosis of the trachea and main bronchi occurred for various reasons.
Bronchoscopy has two types:
- Flexible Bronchoscopy: It is a long and flexible tube. It has a thick pen thickness and there is light on the tip. The instrument has canals to use for biopsy and irrigation processes. The airways can be passed through the nose or mouth because of its flexibility.
- Rigid Bronchoscopy: It is an open, non-flexible tube that can only be administered orally under general anesthesia. It is usually used for foreign body removal or treatment procedures.
Both bronchoscopes have their own advantages. The method to be used is chosen by the physician.
During the procedure, the bronchoscope passes through the mouth or nostril and the vocal cords are reached. If necessary, the vocal cords are administered local anesthesia at this point and the throat is relieved. After passing the vocal cords, the trachea and bronchial structures are inspected. When necessary, a biopsy can be performed via the instruments delivered through the bronchoscopy canal. Irrigation materials are taken from lungs using physiological serum when needed, and submitted for analysis. These procedures are not associated with pain. The procedure takes 10 to 45 minutes. Based on the course of the procedure, this time can change. During the scheduled operation, some unexpected or undesirable situations might be encounter. In such a case, additional interventions can be made by prioritizing the health of the patient.
If this procedure is not performed, the disease may not be diagnosed and thus, may progress. If a disease to be treated by bronchoscopy is then detected, it may not be treated or delayed. If an infectious disease exists, it will continue to to infect other people (for example, in the presence of tuberculosis).
There is a possibility that the disease can be diagnosed with other methods without bronchoscopy. With sputum examinations, pathological and microbiological diagnosis can be made, however, the likelihood of being diagnosed is much lower than with bronchoscopy; if the diagnosis cannot be made by these procedures, the time for the treatment of the disease is lost. Even if lung cancer is diagnosed only by sputum analysis, the stage of the disease may not be determined correctly. Methods such as transthoracic lung biopsy, mediastinoscopy or open lung biopsy are alternative, more invasive methods that can be used for diagnosis and staging.
Success Rate of the Procedure
The success of bronchoscopy depends on the correct indication and the experience of the bronchoscopist, and the expected success rate is usually >80%, but an unforeseen or unexpected condition may be encountered.