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.

• 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)

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.

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.

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

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