[Pediatric flexible endoscopy of the upper airway in the outpatient clinic]

Flexible nasopharyngoscopy has become an important examination of the upper airway in children. It is performed in the outpatient clinic in children of all ages under local anesthesia. We reviewed 190 consecutive examinations of children aged 3 days to 17 years, that were referred to the pediatric ENT clinic between 1999 and 2000. The following parameters were analyzed: demographic details, indications, physical findings, patient cooperation, reliability, and recommendations for further evaluation or treatment. The most common indication for endoscopy was nasal obstruction in 56 patients (30.1%). In this group 25 had an obstructing adenoid and were referred for adenoidectomy. Hoarseness was the second most common complaint in 40 patients (21.5%). Thirty-one of those patients had vocal cord nodules. The most common finding was adenoid hypertrophy in 56 patients (30.1%). No pathology was found in 34 examinations (18.3%). Although a significant correlation between patient cooperation and examination reliability was seen, in most cases good reliability was obtained even in the presence of poor cooperation. The procedure was easy to perform and had no complications. This study emphasizes the advantages of awake flexible nasopharyngolaryngoscopy in the diagnosis of upper airway pathologies in children.