Bronchoscopy
Flexible bronchoscopy
is a procedure designed to safely look into the airways. This includes
the larynx, trachea, and bronchial tree. The procedure is usually performed
in the office or outpatient surgery setting under sedation, however,
in certain circumstances, it is performed before major chest surgery
while the patient is asleep. A small flexible fiberoptic bundle attached
to a light source and lens system is inserted through the nose or mouth.
This allows the surgeon to visualize the airways directly through the
lens in the bronchoscope or on a video screen. Abnormalities of the
tracheobronchial tree can be seen and photographed for future reference.
Also samples of secretions can be obtained, and pieces of tissue can
be removed or biopsied for microscopic examination. The tissue or secretions
can be sent to the microbiology lab for special stains and cultures
to look for potential infections
At right is a view through
the bronchoscope into the trachea. The trachea is composed of partial
rings of cartilage with a membranous back wall. The rings are about
a quarter of an inch wide and are seperated by a soft membrane. One
can barely make out the rings here, especially at the 4 o'clock to 8
o'clock position. One can clearly see the openings of the right and
left main bronchi.
The bronchoscope is useful for visualizing and obtaining biopsies of abnormal tissues in the airways. Depicted at left is an example of a lung cancer poking out of the main bronchus going to the right lung. The tumor is the fleshy, rounded, red mass in the center of the screen. A piece of the abnormal tissue can be removed to confirm the diagnosis. Appropriate therapy can then be recommended once the diagnosis has been made.