Pediatric & Neonatal Bronchoscopy

What is bronchoscopy?

Flexible bronchoscopy involves placing a specialized instrument with a tiny camera at its tip, called a bronchoscope, into the trachea (windpipe) and airways of the lungs.

Bronchoscopy helps the doctor to see if the airways are blocked or narrowed, contain abnormal secretions (mucous) or a foreign body, and are in the right position in the lungs.

A small amount of saline water may also be flushed into the airways and suctioned out so that this fluid can be tested for bacteria, viruses and other disease-causing agents.

The bronchoscopy is videotaped and still pictures are also clicked during the procedure. These pictures are reviewed by the doctor later and then given to the parents.

How is Pediatric Flexible Bronchoscopy Performed?

Flexible bronchoscopy is a critical tool in pediatric pulmonology for several reasons:

Accurate Diagnosis of Respiratory Issues: For children who have persistent or unexplained respiratory symptoms like chronic cough, wheezing, or recurrent infections, flexible bronchoscopy provides a direct view of the airways and lungs. It can help identify conditions like asthma, bronchomalacia, airway stenosis, or congenital lung abnormalities.

Foreign Body Aspiration: Young children are particularly at risk of accidentally inhaling foreign objects (e.g., food, toys, or small objects). Flexible bronchoscopy is the gold standard for locating and removing these objects from the airway safely.

Management of Airway Obstructions: Sometimes, children with severe asthma, cystic fibrosis, or chronic infections may develop airway obstructions that need to be cleared. Bronchoscopy allows the doctor to remove excess mucus or other blockages and restore proper airflow.

Biopsy and Tissue Sampling: If there is concern about a tumor, infection, or abnormal lung tissue, bronchoscopy can be used to obtain tissue samples for further testing, including cultures, cytology, or biopsy.

Minimal Recovery Time: Unlike more invasive procedures like surgery, flexible bronchoscopy is minimally invasive, with a shorter recovery time. Children usually recover quickly and can return to their regular activities within a few hours after the procedure.

Why is Flexible Bronchoscopy Important for Children?

The procedure is typically carried out in a hospital setting, often in an outpatient or specialized pulmonary clinic. Here’s what you can expect during the flexible bronchoscopy process:

Preparation: Before the procedure, your child will be given medications to ensure they are comfortable. Sedation or general anesthesia will be administered to keep your child relaxed and still throughout the procedure.

The Procedure: A small, flexible bronchoscope (a thin tube with a camera at the end) is inserted into the nose or mouth and gently guided down the airways. The doctor will be able to view the airways in real-time on a monitor. If necessary, samples may be taken for testing, or any blockages may be removed.

Post-Procedure: After the procedure, your child will be monitored as they wake up from sedation. They may experience mild discomfort, a cough, or a sore throat, which typically resolves quickly. It’s common for children to resume their regular activities after a few hours of observation.

Will my child be conscious during the procedure?

Child will be given some medications to make him sleepy, relaxed and more comfortable during the test. A pediatric anaesthesia doctor gives these medications so that child does not feel any pain.

Since this test requires sedation, child should not eat or drink anything for 4 hours prior to the procedure. If the child is on oral medicines, that can be given with a small sip of water. If the child is on inhalers, then that inhaler should be given prior to bronchoscopy.

Is flexible bronchoscopy safe for my child?

Yes, flexible bronchoscopy is generally very safe when performed by an experienced pediatric pulmonologist. Your child will be carefully monitored throughout the procedure, and sedation or anesthesia ensures they are comfortable. As with any medical procedure, there are risks, but serious complications are rare.