Upper airway biopsy

Alternative names
Biopsy - upper airway

Definition
A diagnostic procedure in which a small piece of tissue is removed from the upper airway (nose, mouth, throat) for examination.

How the test is performed

The health care provider - ear, nose and throat (ENT); oral surgeon; or pulmonologist (a pulmonary “lung” specialist trained to perform a bronchoscopy) - will spray a topical or local anesthetic in your mouth and throat. Then, a cannula (a metal tube about 6-inches long and curved on one end) is inserted, curved end first, to hold the tongue out of the way.

An anesthetic is injected through the cannula, enabling it to run down the back of the throat. This will cause coughing at first, which will cease as the anesthetic is increased. When the area feels “thick,” it is sufficiently numb.

The suspicious tissue is viewed, and a small piece of tissue is removed using a biopsy punch and sent to the laboratory for examination by the pathologist.

How to prepare for the test
Fast for 6-12 hours before the test. You must sign an informed consent form.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

     
  • infant test or procedure preparation (birth to 1 year)  
  • toddler test or procedure preparation (1 to 3 years)  
  • preschooler test or procedure preparation (3 to 6 years)  
  • schoolage test or procedure preparation (6 to 12 years)  
  • adolescent test or procedure preparation (12 to 18 years)

How the test will feel

Local anesthesia is used to numb the throat, so there may be a feeling of fluid running down the back of the throat or the need to cough or gag as the anesthetic takes effect. There may be sensations of pressure or mild tugging.

When the anesthetic wears off, your throat may feel scratchy for several days. After the test, the cough reflex will return in 1 to 2 hours, then you may eat and drink normally.

Why the test is performed

This test may be performed when an abnormality of the upper airway is suspected. It may also be performed as part of a bronchoscopy when abnormalities include the upper airway as well as the lung tissue.

Normal Values
There are normal upper airway tissues, with no abnormal growths or inclusions.

What abnormal results mean
Disorders or conditions that may be discovered include:

     
  • granulomas (may be caused by tuberculosis)  
  • granulomatous inflammation (may be caused by tuberculosis)  
  • necrotizing vasculitis  
  • cancer

What the risks are

     
  • sore throat  
  • breathing difficulties (minimal risk)  
  • bleeding (some bleeding is common, excessive bleeding is not)

There is a significant risk of choking if anything (including water) is ingested before the anesthetic wears off.

Special considerations
Not applicable.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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