Pediatric bronchoscopy
A pediatric bronchoscopy is a procedure to diagnose conditions that affect the airways. At Children's Health℠, our pulmonary (lung) team uses bronchoscopy and other tools to determine the best treatment plan for your child. Our experts include pediatric pulmonologists (doctors who specialize in lung conditions), otolaryngologists (ear, nose and throat (ENT) specialists), and other highly trained providers. The team has advanced training and experience in all conditions that affect the airways, lungs and respiratory system, from the common to the complex. We provide the highest level of care for your child and family from diagnosis through treatment.
What is a pediatric bronchoscopy?
A bronchoscopy is a minimally invasive procedure that doctors use to examine a child’s airways. Doctors use a bronchoscope (narrow tube-shaped instrument with a light and camera) to complete the procedure. The bronchoscope enables doctors to view inside the throat, windpipe (trachea), voice box (larynx), bronchial tubes, lungs and lymph nodes.
Doctors use bronchoscopy to:
- Find the cause of problems affecting the airways, such as a persistent cough or difficulty breathing
- Take samples of tissue or mucus for testing (biopsies)
- Remove an object that is blocking the airway
- Provide treatment for some airway problems
The two types of bronchoscopies are flexible and rigid.
- Flexible bronchoscopy - A flexible bronchoscopy uses a thin, bendable tube and helps doctors view narrower parts of the airways. This is the most common form of bronchoscopy.
- Rigid bronchoscopy - A rigid bronchoscopy uses a straight, unbendable tube that enables doctors to have a complete view of large airways. This tool and technique aren’t used often. A doctor might use a rigid bronchoscopy to remove an object or perform procedures, such as placing a stent (small tube) to keep the airway open.
What are the benefits of a pediatric bronchoscopy?
A key benefit of a bronchoscopy procedure is that it’s minimally invasive. That means children need very little recovery time.
What are the side effects of a pediatric bronchoscopy?
It’s common for children to experience a sore throat after a bronchoscopy procedure. This side effect usually goes away on its own within a few days and doesn't require treatment.
What are the risks of a pediatric bronchoscopy?
Pediatric bronchoscopy is a safe procedure. Complications are very rare and typically minor, but all medical procedures have some risks.
Bronchoscopy risks include:
- Bleeding (if biopsies are taken)
- Congestion
- Fever
- Infection
There is also a very small risk of a partially collapsed lung, which is treatable and children can make a full recovery. Our team is highly experienced in keeping all risks to an absolute minimum.
What to expect with a pediatric bronchoscopy
Pediatric bronchoscopies take about four to six hours, including the prep, procedure and time in the recovery room. Most bronchoscopies are outpatient procedures. That means most children won’t need to stay in the hospital, and they can go home after they recover from the procedure.
In some complex cases, children are already in the hospital when they undergo a bronchoscopy. For those children, this procedure is part of their diagnostic or treatment plan.
What to expect before a pediatric bronchoscopy
Child life specialists will explain the procedure to your child in an age-appropriate way to help them feel as comfortable as possible. Our team will evaluate your child to prepare them for the procedure, including checking their vital signs and asking about any medications they are taking. The team can also answer any questions or concerns you have about the bronchoscopy procedure.
Your child may need other diagnostic tests, such as imaging, in addition to the bronchoscopy. If so, our team of experts coordinates to complete all the tests in the most efficient way.
What to expect during a pediatric bronchoscopy
The pediatric bronchoscopy procedure takes about 30 to 60 minutes. Here’s what to expect during the procedure:
- An anesthesiologist will give your child medicine that makes them drowsy, relaxed and comfortable (sedation) during the procedure. In rigid bronchoscopies, your child will be “asleep” with general anesthesia. An anesthesiologist will also give your child medicine to numb the nose and throat so they won’t feel the bronchoscope.
- The doctor inserts the bronchoscope through the child's nose or down a special tube in the throat.
- The doctor slowly moves the bronchoscope to the areas they need to view. They may use other tools if they need to take biopsies or provide treatment.
- Once the procedure is complete, the doctor gently removes the bronchoscope. Our team moves your child to a recovery room to wake up from sedation or general anesthesia.
What to expect after a pediatric bronchoscopy
You can meet your child in the recovery room to be with them as they wake up. Children typically spend one to three hours in recovery after bronchoscopy. The sedation and numbness in their throat slowly wears off. They can begin to eat and drink normally after they regain feeling in their throat.
While in recovery, your doctor will meet with you to discuss the next steps in your child’s diagnostic or treatment plan. After recovery, most children are discharged home and can resume their typical activities.
How do I prepare my child for a pediatric bronchoscopy?
Is my child allowed to eat and drink before a pediatric bronchoscopy?
No, a bronchoscopy requires an empty stomach. Before the procedure, you will receive specific instructions about when your child should stop eating and drinking based on your child’s age.
What are the prep instructions for a pediatric bronchoscopy?
To reduce the risk of bleeding during the procedure, your child should avoid taking these medications for at least a week before the bronchoscopy:
- Aspirin
- Ibuprofen (Motrin®)
- Naproxen sodium (Aleve®)
Our team will review your child’s medications and instruct you if and when your child should stop taking any other medicine before the procedure.
What are the child life services for a pediatric bronchoscopy?
Child Life specialists work with your child before the procedure to teach them about bronchoscopy in a way they understand. We answer their questions and help put them at ease before the procedure.
If doctors make a diagnosis after the bronchoscopy, Child Life can continue to work with your child. We help them understand a diagnosis and what to expect with treatment and feel as comfortable as possible about their care.
What questions should I ask my provider about a pediatric bronchoscopy?
- What medications should my child stop taking before the bronchoscopy?
- How soon will I be able to see my child after the bronchoscopy?
- When will we have the results of the bronchoscopy?
Pediatric bronchoscopy doctors and providers
Our expert team specializes in bronchoscopy and other diagnostic tools to determine the cause of problems affecting the airway – from the most common to the most complex. They work together to diagnose your child’s condition and develop the best treatment plan to meet their unique needs.
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Romaine Johnson, MD Pediatric Otolaryngologist (ENT) -
Devika Rao, MD Pediatric Pulmonologist -
Peter Schochet, MD Pediatric Pulmonologist -
Stephen Chorney, MD Pediatric Otolaryngologist (ENT)
Frequently Asked Questions
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Why would a child need a pediatric bronchoscopy?
Bronchoscopy is a diagnostic and treatment tool for a wide variety of problems that affect the airways, including:
- Airway blockage caused by foreign body aspiration (inhaled object)
- Persistent cough of more than three months with no explanation
- Difficulty breathing
- Lung and respiratory infections
- Changes in chest X-rays
- Children's interstitial lung disease (chILD), a group of more than 30 lung disorders that can affect children
- Tracheal stenosis (narrowing or strictures in the airway)
- Inhaled toxic substances (such as gases or chemicals)
- Tumors
- Collapsed lung
- Cystic fibrosis (CF)
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Is it painful to have a pediatric bronchoscopy?
Your child receives either sedation medication to relax them or general anesthesia to help them sleep during the procedure. They also receive medication to numb their throat so they don’t feel pain during the bronchoscopy. Some children have a sore throat after the procedure, but it goes away on its own.
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Is a pediatric bronchoscopy considered surgery?
No, bronchoscopy is a procedure, but it’s not surgery. With bronchoscopy, doctors insert a narrow scope through the nose or mouth to examine the respiratory system without surgery.
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Are bronchoscopies safe for children?
Yes, bronchoscopy is a safe procedure for children. Complications are very rare, and if they occur, they’re typically minor and don’t require treatment.
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Is a child awake during a pediatric bronchoscopy?
Children may receive sedation medicine so they are comfortable and calm for the procedure. Some children are “asleep” under general anesthesia.