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Fiberoptic bronchoscopy is a medical imaging technique used to view the airways and obtain samples from the tissues of the lungs. A bronchoscopy may be required to diagnose and treat a number of conditions such as lung collapse or atelectasis, blockages of the airways in the lungs by a tumor or a foreign object, or a lung infection that causes inflammation and a build-up of mucus. Fiberoptic bronchoscopy may also be used to remove a foreign object that is trapped in the airways and in this way help the lungs function normally again. Other indications for a bronchoscopy include bleeding in the lungs, a lung spot that shows up in chest x-rays, and in the diagnosis of infections such as pneumonia, tuberculosis, and AIDS related chest infections. The CPT code for fiberoptic bronchoscopy is 31622.

The procedure of a fiberoptic bronchoscopy involves the use of a thin tubular instrument that is inserted into the lungs via the nose or the mouth. This tube is fitted with a tiny fiberoptic camera that provides internal images of the airways and tissues in the lungs. These images are viewed on a monitor while the procedure is being performed. This tube can be flexible or rigid and is less than an inch wide and more than two feet long. A flexible bronchoscope is more commonly used and the procedure is normally carried out with the patient awake. To lessen any discomfort a numbing medicated spray will be applied to the mouth or throat. If the tube is inserted via the nose, a numbing gel will be applied. If the patient is too agitated, a relaxant will be administered intravenously but general anesthesia is rarely used. If a biopsy has to be done along with the bronchoscopy, tiny forceps or needles may be passed through the bronchoscope.

Some of the risks associated with a bronchoscopy are:

• If the lung is severely damaged already or very inflamed, there is a high risk of leakage or further collapse of the lung. While not very common, this risk increases if a biopsy is conducted along with the bronchoscopy.
• In some cases, a fluid may be injected into the lung to make the images clearer. This fluid that gets left behind in the lungs may cause a drop in the level of oxygen in the blood for a few hours after the procedure. This is kept in check by monitoring the level of oxygen in the lungs both during and after the procedure.
• In case of injury of the airways or a tumor during a bronchoscopy, there is a possibility of internal bleeding. Usually minor bleeding stops on its own or medications may be required to halt the bleeding. In very rare cases does the bleeding lead to further complications or death.

References

• http://www.nlm.nih.gov/medlineplus/ency/article/003857.htm