The bronchoscope is a small, flexible tube that can be easily passed through a child's nose. The flexible tube carries a fiber optic system that attaches to a video camera and light source. The image from the open end is transmitted through the fiber optic system to a video camera.
A trans-nasal flexible fiber optic bronchoscopy is a procedure where a physician examines various parts of your child's respiratory system using a device called a bronchoscope. These definitions may help you understand the procedure and its tools:
- Trans-nasal: When the soft, flexible tube of a bronchoscope is passed through the child's nose
- Flexible bronchoscopes: A device that's soft, flexible and easily passed through the nose and airways in the lungs, which allows clinicians to see inside these hard-to-reach places
- Fiber optic bronchoscope: A device using fiber optic technology to transmit an image from the tip of the tube to a video camera
- Bronchoscopy: An evaluation of the respiratory system, including voice box (larynx), wind pipe (trachea) and the airways (bronchi) to see if there are signs of an abnormality. Your child's physician can see these structures during different stages of the breathing cycle and monitor the progress of any abnormalities.
In a bronchoalveolar lavage (BAL), the physician injects a small amount of saline through the bronchoscope into the airways and then sucks it back through the bronchoscope. The fluid obtained contains saline plus secretions, bacteria (if present) and cells. This sample is sent to the laboratory for various tests.
Your child will not be allowed to eat or drink for four hours prior to the procedure. This is very important in order to avoid vomiting.
Once your child arrives, our staff will take height and weight measurements and vital signs. Your child is then brought to the procedure suite and examined. You will be asked a series of questions.
Your child will receive an intravenous (IV) line. Monitors are attached to your child in order to watch vital signs. Small children may need to be swaddled. Children will not be restrained unless absolutely necessary for their safety.
At UChicago Medicine Comer Children's Hospital, our experts take every step to ensure the safety and comfort of your child. Typically, a flexible bronchoscopy is not done under general anesthesia, but your child will be given medications through an IV for sedation. Your child will be able to wake from this deep sleep.
Numbing drops will be used to numb the nose, back of the throat, larynx, trachea and bronchi. Lidocaine prevents irritation, cough and sneezing.
Once the numbing medication takes effect, the bronchoscope is inserted.
Once the IV is in and all monitoring equipment is attached, the procedure takes less than 15 minutes to complete. If a bronchoalveolar lavage is needed, this takes a few additional minutes.
After the procedure, your child will be monitored while the effect of sedation and numbing medicine wears off — usually about 30 minutes. Your child must be fully awake, able to drink clear fluids and no longer exhibit signs of sedation before going home. The full recovery process takes around an hour. Your child's physician or nurse will be able to tell you the approximate time for your child.
Your child's doctor will give you personalized instructions prior to the bronchoscopy. This information will instruct you not to feed your child for four to six hours before the procedure.
If your child is old enough, explain as much as much as you feel is appropriate.
The following information will help ensure a smooth procedure:
- Pack one or two favorite toys, blankets or activities to help your child relax before and after the procedure.
- Pack a favorite snack or lunch. Your child will have to eat before being allowed to go home.
- Make sure you know the names and amount of any medications your child is taking — or bring the bottles with you.
- If your child has any other medical condition, you will need to tell the physician performing the procedure.
Although each child is different, there are usually little or no side effects from this procedure. Some of the possible side effects include:
- Fever: A mild fever may occur but is rare. Over-the-counter fever medicine will help.
- Nosebleed: Since the lining of the nose is very delicate, a nosebleed may occur. Typically, it will stop on its own.
- Noisy breathing: A change in voice or noisy breathing may occur, but it is usually temporary.
- Wheezing: Some children with a history of lung disease, such as asthma, may need additional medication to treat signs of wheezing both prior to and after the procedure.