N Bhat1, R De, H Zeiton. 1. West Midlands Rotation in Otolaryngology, Edgebaston, Birmingham, United Kingdom. nbhat98255@aol.com
Abstract
OBJECTIVES: To review all paediatric endoscopies performed in a tertiary referral unit over a three-year period. METHODS OF STUDY: Retrospective analysis of case-notes of all paediatric endoscopies performed between May 1993 and June 1996. RESULTS: 333 paediatric airway endoscopies were performed on 146 children, of which 52% were GP referrals and the remainder secondary referrals. 70% were diagnostic endoscopies, 30% therapeutic procedures, with the commonest indication being stridor and respiratory distress (82%). Routine chest radiographs, lateral neck X-rays, and barium swallows were unhelpful in the management of the commoner upper-airway conditions. The commonest findings were laryngomalacia (44%) and subglottic stenosis (22%) and 17% of all cases had multiple airway abnormalities. Tracheotomy was performed on 18.4%, laryngotracheoplasty on 7.5%, and laryngotracheal reconstruction on 2.5%. There were no major complications in this series. CONCLUSIONS: All children with airway symptoms should have a thorough rigid-endoscopic evaluation of their upper and lower airways. Radiology has a limited role in the diagnosis of the more common airway pathologies. These patients need to be assessed and managed in regional centres.
OBJECTIVES: To review all paediatric endoscopies performed in a tertiary referral unit over a three-year period. METHODS OF STUDY: Retrospective analysis of case-notes of all paediatric endoscopies performed between May 1993 and June 1996. RESULTS: 333 paediatric airway endoscopies were performed on 146 children, of which 52% were GP referrals and the remainder secondary referrals. 70% were diagnostic endoscopies, 30% therapeutic procedures, with the commonest indication being stridor and respiratory distress (82%). Routine chest radiographs, lateral neck X-rays, and barium swallows were unhelpful in the management of the commoner upper-airway conditions. The commonest findings were laryngomalacia (44%) and subglottic stenosis (22%) and 17% of all cases had multiple airway abnormalities. Tracheotomy was performed on 18.4%, laryngotracheoplasty on 7.5%, and laryngotracheal reconstruction on 2.5%. There were no major complications in this series. CONCLUSIONS: All children with airway symptoms should have a thorough rigid-endoscopic evaluation of their upper and lower airways. Radiology has a limited role in the diagnosis of the more common airway pathologies. These patients need to be assessed and managed in regional centres.
Authors: Kevin Kulendra; Joseph Mullineux; Ann-Louise McDermott; Helen Williams Journal: Eur Arch Otorhinolaryngol Date: 2012-10-19 Impact factor: 2.503