Rigid or flexible laryngoscope: The preference of children

The aim of this study was to evaluate the effects of flexible and rigid endoscopes using a visual analog scale and reveal which one is better tolerated by children.

The pediatric patients with voice disorders examined between July 2012 and October 2014 were included the study. Patients to whom endoscopic visualization had been applied several times were recalled for information about their preference of scope. No local anesthetics were used before both procedures. Pain sensation, gag reflex or vomiting and dyspnea or breathiness were evaluated and graded using a visual analog scale (VAS).

A total of 35 patients (77.1% males, 22.9% females) with a median age of 11.3±1.8 years (range, 7-15 years) were analyzed. Group 1 consisted of patients who preferred videolaryngostroboscopy (VLS) and Group 2 consisted of patients who preferred flexible fiberoptic nasopharyngoscopy (FFN). Overall, 28 (80%) of the patients preferred videolaryngostroboscopy (VLS) while 7 (20%) of the patients preferred FFN examination. In these examinations 20 patients (57.1%) felt pain, 17 (48.6%) felt irritation, 5 (14.3%) had gag reflex, and 2 (5.7%) had dyspnea. According to this data, the VLS (VAS) scores regarding gag reflex (p=0.017) and dyspnea domains (p=0.022) of the group who preferred FFL were statistically higher than those of the VLS group. No statistically significant difference was determined between the genders in respect of the VLS and FFL scores in all domains. Pain and irritation were the most prominent findings in patients who were reluctant to be examined by FFL. Irritation was statistically significantly higher in Group 1 (p=0.004). Gag reflex was the most disturbing finding described by patients who were reluctant to be examined by VLS.

In this study, most of the children (80%) preferred rigid laryngoscopy rather than flexible fiberoptic laryngoscopy. Pain and irritation were the most prominent findings for patients who were reluctant to be examined by FFL. Rigid laryngoscopy can be recommended rather than FFN for evaluation of children with vocal fold pathologies.