This procedure provides direct visualization of the larynx, trachea, and bronchial tree by means of either a rigid or a flexible bronchoscope. A fiberoptic bronchoscope with a light incorporated is guided into the tracheobronchial tree. A local anesthetic may be used to allow the scope to be inserted through the mouth or nose into the trachea and into the bronchi. The patient must breathe during insertion and with the scope in place. The purpose of the procedure is both diagnostic and therapeutic.

The rigid bronchoscope allows visualization of the larger airways, including the lobar, segmental, and subsegmental bronchi, while maintaining effective gas exchange. Rigid bronchoscopy is preferred when large volumes of blood or secretions need to be aspirated, foreign bodies are to be removed, large-sized biopsy specimens are to be obtained, and for most bronchoscopies in children.

The flexible fiberoptic bronchoscope has a smaller lumen that is designed to allow for visualization of all segments of the bronchial tree. The accessory lumen of the bronchoscope is used for tissue biopsy, bronchial washings, instillation of anesthetic agents and medications, and to obtain specimens with brushes for cytological examination. In general, fiberoptic bronchoscopy is less traumatic to the surrounding tissues than the larger rigid bronchoscopes. Fiberoptic bronchoscopy is performed under local anesthesia; patient tolerance is better for fiber-optic bronchoscopy than for rigid bronchoscopy.