ABSTRACT
Bronchoscopy allows for evaluation of the lower airways when clinical suspicion of anatomical defects, infection, and parenchymal disorders exists. Flexible endoscopy remains the preferred modality for examining the airways beyond the mainstem bronchi, due to the size and flexibility of the instruments; however, rigid bronchoscopy is frequently performed in tandem with flexible bronchoscopy when upper airway evaluation or proximal airway interventions are necessary. Flexible tools also serve as conduits by which trained bronchoscopists can perform specialized interventions to obtain the tissue samples from the distal airways and neighboring intra-thoracic structures which are often required to establish specific diagnoses. The indications for and approach to lower airway investigation, with a focus on flexible bronchoscopy and associated interventional techniques, are described within this review.
