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Pediatric bronchoscopy during a 17-year period
H Puhakka1, P Kero, M Erkinjuntti
1Department of Otolaryngology, University Central Hospital, Turku, Finland.
Insights
Pediatric bronchoscopy is a valuable diagnostic tool for children, identifying conditions like foreign bodies and stridor. This study highlights its safety and effectiveness in diagnosing various pediatric airway disorders.
Area of Science:
- Pediatric Pulmonology
- Pediatric Gastroenterology
- Pediatric Otolaryngology
Background:
- Pediatric airway disorders require accurate diagnosis.
- Bronchoscopy is an established endoscopic procedure for evaluating the pediatric airway.
Purpose of the Study:
- To analyze the indications, findings, and complications of pediatric bronchoscopy.
- To assess the diagnostic yield of bronchoscopy in children under 16.
Main Methods:
- A retrospective review of 1032 pediatric bronchoscopies performed between 1969 and 1985.
- Procedures were conducted on 748 children under 16 years, including infants as young as 6 months.
- Both rigid and flexible bronchoscopes were utilized under general anesthesia.
Main Results:
- Common indications included foreign body aspiration (16.7%), stridor (14.5%), and recurrent respiratory infections (12.3%).
- Laryngomalacia was a frequent finding (13.8%), particularly in infants with inspiratory stridor (39.8%).
- Significant diagnoses included tracheal compression (10.8%) and subglottic stenosis (7.0%).
Conclusions:
- Pediatric bronchoscopy is crucial for diagnosing a wide spectrum of airway abnormalities in children.
- The procedure demonstrated a low complication rate, supporting its safety in this population.
- A high percentage of procedures revealed significant findings, underscoring its diagnostic utility.
Abstract:
From 1969 through 1985, 1032 pediatric bronchoscopies were performed on a total of 748 children under 16 years of age. Of the children 27.4% were under 6 months of age and the smallest patient weighed 600 g. Rigid bronchoscopes with a diameter ranging from 2.5 to 6 mm were used. A flexible fiberoptic bronchoscope with a diameter of 3.5 mm was used only occasionally, mostly for the diagnosis of laryngeal dynamics. All the endoscopies were performed under general anesthesia, except for some laryngoscopies performed with a flexible bronchoscope. The most common indications for bronchoscopy were suspected foreign body (16.7%), stridor (14.5%), recurrent respiratory infections (12.3%) and dyspnoe (9.6%). Laryngomalacia was observed in 13.8% of the children investigated and in patients with inspiratory stridor laryngomalacia was diagnosed in 39.8% of the cases. Subglottic stenosis was confirmed in 7.0% of the children. Tracheal compression was found in 10.8% and tracheal stenosis in 2.5% of the cases. Bronchiectasis was observed in 2.5% and tuberculosis in only 0.5% of the cases. Bronchoscopy was completely normal in only 10.6% of the patients investigated. The complications of pediatric bronchoscopy in this series were infrequent.