Learning About Endobronchial Ultrasound

Endobronchial ultrasound (EBUS) is a procedure that uses ultrasound (images made from sound waves) to look at the lymph nodes, airways, and lungs. It's done during another procedure called a bronchoscopy.

There are two types of EBUS:

• Radial probe EBUS (RP-EBUS). This gives your doctor a 360-degree view of the airway wall and surrounding structures. It can provide more detailed images. But it can't be used to take a tissue sample (biopsy) for testing. It acts as a visual guide.
• Convex probe EBUS (CP-EBUS). This method is usually used when your doctor needs to take a tissue sample. It can guide the probe and biopsy tools.

EBUS is used to diagnose different types of lung disorders, including inflammation, infections, and cancer. It can help confirm a diagnosis. It may be used to do a biopsy or to guide other procedures.

You will be given a sedative to help you relax. You may have an intravenous (I.V.) line placed in a vein. You will remain awake but will be sleepy during the procedure. In some cases, you may have general anesthesia to make you sleep.

Before the procedure, your doctor usually sprays a numbing medicine into your nose and mouth. This numbs your throat and reduces your gag reflex during the procedure. Your doctor may also place a numbing ointment in your nose to numb your nasal passages.

Your doctor gently and slowly inserts a thin flexible tube called a bronchoscope through your mouth (or nose). It is important to avoid trying to talk while the scope is in your airway. Once the scope is in place, your doctor will insert the ultrasound probe through the scope. This allows your doctor to see your lungs and airways.

An X-ray machine (fluoroscope) may be placed above you to provide a picture that helps your doctor see any devices that are being used to collect a tissue sample.

If your doctor collects tissue samples for biopsy, a tiny biopsy tool or brush will be used through the scope. The samples are collected and sent to the lab to be studied.

Finally, small biopsy forceps may be used to remove a sample of lung tissue. This is called a transbronchial biopsy.

After an EBUS, you will be observed for 1 to 3 hours until the medicines wear off. Don't eat or drink until feeling returns to your throat and you are able to swallow without choking. After that, you may resume your normal diet when your doctor says it's okay, starting with sips of water.

Most people go home the same day. If you go home on the day of your procedure, someone will need to drive you home.

You may feel tired for 1 or 2 days. Your mouth may feel very dry for several hours after the procedure. You may also have a mild cough, sore throat, and hoarse voice for a few days. Sucking on throat lozenges or gargling with warm salt water may help soothe your sore throat. If a sample of tissue (biopsy) was taken, you may spit up a small amount of blood or have bloody saliva. This is normal.

EBUS is generally a safe procedure. Problems are rare. But your doctor will discuss any risks with you. Problems that may occur include:

• Spasms of the bronchial tubes, which can impair breathing.
• Irregular heart rhythms (arrhythmias).
• Infections, such as pneumonia. These can usually can be treated with antibiotics.
• Ongoing hoarseness.

If a biopsy was done, problems that may occur include:

• A tear in the lung from the biopsy forceps used to collect a tissue sample. This may cause a partial collapse of the lung (pneumothorax).
• Bleeding caused by the biopsy forceps used to collect the tissue.
• An infection from the biopsy procedure.
• A very small chance of death.

Your doctor may discuss your results with you soon after the procedure. Test results on any biopsy samples are usually available in 2 to 4 days.