Balloon Bronchoscopy

What is a Balloon Bronchoscopy?

Bronchoscopy is a minimally invasive procedure that allows your respiratory specialist to observe the insides of your respiratory tract. Bronchoscopies are often used in the diagnosis of various respiratory conditions such as haemoptysis (coughing up blood), interstitial lung disease (ILD), lung nodules, pleural effusion, and pneumonia. 

A long, thin tube, also known as a bronchoscope, with a light and camera attached at one end is inserted into your nose or mouth and gently guided down your trachea (windpipe) and into the lower respiratory tract. There are two types of bronchoscopes:

• Flexible bronchoscope: a flexible tube that can be inserted into the smaller airways such as the bronchioles.
• Rigid bronchoscope: a straight tube used in the larger airways.

A balloon bronchoscopy is a gentle, less traumatic way of opening up the narrowed wind pipes. It can be used with both flexible and rigid bronchoscopes.

How does a Balloon Bronchoscopy work?

Balloon dilatation via bronchoscopy is done by passing a small deflated balloon in to the narrowed wind pipes and inflating it. The inflation of the balloon helps to stretch open the narrowed wind pipe. Balloons are made of silicone, available in 3 different sizes, and uses radial pressure to open up airways. 

• An anaesthesia will be administered intravenously to help you relax and remove any discomfort you may feel. 
• A numbing medicine will be sprayed onto the back of your throat and then the bronchoscope is slowly and gently inserted into your nose or mouth and guided down your trachea (windpipe) and into your lower respiratory tract. 
• Once the bronchoscope reaches the site of obstruction, a balloon is inserted into the bronchoscope.
• The balloon is guided through the bronchoscope to the obstruction and inflated using an inflator gun.
• The first inflation is done at the lowest pressure for approximately 2 minutes, then deflated and removed.
• This process is repeated with increasing pressure two more times until adequate dilation of the airways is obtained.
• Once the appropriate dilation is obtained, the bronchoscope is removed.

What happens after a Balloon Bronchoscopy procedure?

You may feel a bit groggy after the procedure, so you will be monitored for a few hours to ensure that you recover well. A chest x-ray might be performed after the balloon bronchoscopy to ensure that no damage was done to your lungs. 

Your throat might still feel numb from the numbing medicine so you will not be allowed to eat or drink until you recover. Your respiratory specialist will advise you on when you may return to your normal activities and diet. 

Who needs a Balloon Bronchoscopy?

A balloon bronchoscopy is required for individuals with collapsed or blocked and obstructed airways, such as:

• Tracheal stenosis: abnormal narrowing of the trachea due to long-term intubation.
• Narrowing of the subglottis: where a portion of the windpipe is narrowed and obstructed.
• Narrowing of the bronchial tube: part of the bronchial tube may be narrowed due to tuberculosis infection.

How do I prepare for a Balloon Bronchoscopy in Singapore?

Before the procedure, you must avoid eating and drinking for 6-12 hours and you may be required to stop certain medications such as blood thinners and aspirin. Either a sedative or general anaesthesia will be used during the procedure, depending on your preference and advice of your respiratory specialist. 

What are the benefits? 

• Less traumatic than a rigid bronchoscopy
• Reduces the risk of a repeat blockage
• Size of dilation can be controlled

What are the possible complications or risks of a Balloon Bronchoscopy in Singapore?

There are minimal to no risks or complications involved in a balloon bronchoscopy, however, if they do occur, this is what to look out for:

• Adverse reaction to anaesthesia
• Bleeding
• Pneumothorax (collapsed lungs)
• Fever 

Frequently asked questions